-r ^m^m , 



** 




v->^ 



**, 



# i 



.<% 



*> 



te« 



* 



. •* • 



<■ -/ 



f\L ^ *L 












LIBRARY OF CONGRESS. 



Cljap. 

|UXITED STATES OF AMERICA.l 






AN ESSAY 



TO PROVE THE 



CONTAGIOUS CHARACTER 



OF 



MALIGNANT CHOLERA. 



' 



AN ESSAY 



TO PROVE THE 



CONTAGIOUS CHARACTER 



OF 



MALIGNANT CHOLERA; 



WITH BRIEF INSTRUCTIONS 



FOR ITS 



PREVENTION AND CURE, 



BY 

BERNARD M. BYRNE, M. D. ? 

SURGEON TJ. S. ARMY. 



SECOND EDITION, 

WITH ADDITIONAL NOTES BY THE AUTHOR. 



The promulgation of every truth is, in its general effects, beneficial — that of every errcr, 

mischievous. 



PHILADELPHIA: 

CHILDS & PETERSON, 

No. 124 Arch Street. 

1855. 






Entered according to the Act of Congress, in the year 1855, by 

CHILDS & PETERSON, 

Tn the Clerk's Office of the District Court of the Eastern District of 

Pennsylvania. 



TO 



NATHAN R. SMITH, M. D. 



! i"-' -*"! 



PROFESSOR OF SURGERY IN THE UNIVERSITY OF MARYLAND, 



THE FOLLOWING ESSAY 



IS MOST RESPECTFULLY DEDICATED 



BY HIS FRIEND, 



THE AUTHOR. 



From Dr. J. K. Mitchell, Professor of the Practice of 

Medicine, in Jefferson Medical College, Philadelphia. 

f 

Messrs. Childs & Peterson, 

Gentlemen — I have perused with attention and plea- 
sure, the Treatise of Dr. Byrnes, U. S. A., on Cholera. 
Until very lately, the profession throughout the world, 
rejected the doctrine of its contagiousness ; but as medi- 
cal men every where begin to lean towards an opposite 
opinion, this work will make its appearance opportunely. 
Its method, style, doctrine, and practical wisdom, entitle 
it to the careful perusal of every practitioner in the 
country. 

With respect, 

Yours, 

J. K. MITCHELL, M. D. 



CONTENTS 



Contagion in General, - -, - •• - 21 

Progressive Atmospheric Influence, - - - 28 

Local Atmospheric Influence, - - - * 37 

Terrestrial Emanations, - - - - 38 

Human Intercourse, ----- 40 

General Facts, - - •> - - 42 

Particular Facts, ------ 68 

Objections of the Non-contagionists, - - - - 97 

Evils of the Doctrine of Non-contagion, - - - 124 

Prevention of Cholera, - - - - - 134 

Treatment of Cholera, ----- 149 



PREFACE 

TO THE SECOND EDITION 



When the first edition of this Essay was published, in 
the Fall of 1833, there were comparatively but few 
physicians in the United States, and I may add, in 
Europe, who believed in the contagiousness of cholera. 
So generally was the non-contagiousness of this disease 
proclaimed by the medical profession, by the newspaper 
press, and consequently by the public voice, that the 
few contagionists, rari nantes in gurgite vasto, who here 
and there ventured to advance their views in opposition 
to such a world-weight of authority, were looked upon 
as " presumptuous eccentrics," who sought distinction 
by the singularity of their opinions. As some evidence 
of the very small proportion of medical men who, at that 
time, believed in the contagiousness of cholera, I may 
cite the city of Baltimore, where, in 1832, out of about 
one hundred and forty physicians, there were not more 
than two,* besides myself, who acknowledged their be- 
lief in the contagiousness of this disease. At present 
the case is very different. The progress of this pesti- 
lence over the United States, as over everv other coun- 

* Professor Nathan R. Smith and Dr. Richard H. Steuart. 



X PREFACE. 

try, presented innumerable facts of an unequivocal cha- 
racter in proof of its contagiousness. Each visitation of 
the disease, developed, at every step of its march, new 
facts in favor of this doctrine ; and so overwhelming is 
the evidence which the last twenty-two years have 
accumulated, that many of the ablest and firmest non- 
contagionists, have yielded to its force, and candidly pro- 
claimed their conversion. 

There is still, however, a large proportion of the 
medical profession that adheres to the opinion that cho- 
lera is not contagious, and that still attributes its pro- 
gress to "atmospheric influences," " local origin," and 
a variety of other exploded hypotheses, which have 
served so long to bewilder and delude the public mind. 
Every speculation that the most ingenious minds could 
imagine, has been resorted to by the non-contagionists in 
their efforts to explain the progressive cause of cholera; 
but without the least success. Each hypothesis gave 
way to one equally untenable, till speculation itself be- 
came exhausted, and they were at length forced to 
acknowledge that, after an unremitting investigation of 
thirty-seven years, they had not been able even to im- 
agine a plausible hypothesis to explain its progress. 
The hypotheses of " atmospheric intemperament," 
"local origin,"" "telluric influence," &c, having been 
proved utterly irreconcilable with the progressive phe- 
nomena of cholera, the great majority of the non- 



PREFACE. XI 

contagionists, have of late, abandoned all speculation on 
the subject — pronounced its progress a " mystery" — 
and found their sole occupation in opposing the doctrine 
of contagion. Had they succeeded in disproving the 
truth of this doctrine, also, they would then have estab- 
lished the deplorable and humiliating fact, that the 
mode by which cholera traverses the earth, is indeed a 
mystery, — and that the combined intellectual efforts of 
the whole medical world have not been able, in thirty- 
seven years of unwearied investigations, to shed one ray 
of light on the subject. But, fortunately for the inte- 
rests of humanity, and for the credit of the medical pro- 
fession, they have failed as signally in disproving the 
truth of the contagiousness of this disease, as they have, 
in divining any other mode to explain its progress. 

The question whether cholera be a contagious disease, 
or whether its propagation be owing to a cause or causes 
independent of human intercourse, is one of vast import- 
ance ; for, unless the mode by which it is propagated, 
can be positively ascertained and established, it will be 
in vain to hope that its progress can be successfully 
opposed. Thirty-seven years have now passed, since 
cholera first made its appearance in India, and during 
that period there is scarcely a portion of the habitable 
globe that has not been visited, and re-visited, by this 
travelling pestilence. Yet strange to say, notwithstand- 
ing the vast extent of its travels, and the innumerable 



Xll PREFACE. 

places which it has visited, the mode of its progress 
remains still as great a mystery to a large proportion of 
the medical profession, (the non-contagionists,) as it was 
in the year when it commenced its ravages ! 

If all those sects that opposed the doctrine of conta- 
gion, had candidly avowed their entire ignorance of the 
mode by which this pestilence diffuses itself over the 
world, — and had, therefore, consistently abstained from 
giving any advice respecting its prevention, — their spe- 
culations on the subject, would have been productive of 
no direct mischief. But unfortunately, they have not 
contented themselves with merely theorizing in oppo- 
sition to the doctrine of contagion. Each non-contagion 
sect did not scruple to promulgate its unsupported, and 
oft-reputed hypothesis, in the confident tone of an 
established truth; and constituting, as these various 
sects did, the great majority of the medical profession, 
they have, from the commencement, swayed the public 
mind, and, with rare exceptions, governed public mea- 
sures on this most important subject. If it be true that 
cholera is a contagious disease, it cannot be disputed 
that the very general prevalence of the opposite doctrine 
has caused immeasurable evil. The non-contagionists 
unreservedly denounced quarantine restrictions of every 
description — and did not hesitate to proclaim, in the 
tone of professional authority, that there was no danger 
whatever in communicating with the sick. The antago- 



PREFACE. Xlll 

nists, on the contrary, recommended quarantine restric- 
tions in every instance in which such restrictions offered 
a rational prospect of success ; and they emphatically 
warned the public against exposing themselves, unneces- 
sarily, at the bedsides or in the neighborhood of the 
sick. If the contagionists erred in giving this advice, 
they erred on the safe side, and were justified in giving 
it, if there existed nothing more than a suspicion that 
the disease was contagious. That this suspicion did 
exist, even in the minds of the non-contagionists, will 
hardly be denied, and how they can reconcile the advice 
which they gave with the grave responsibility that de- 
volved on them as guardians of the public health, it is 
difficult to conceive. If the views of the contagionists 
be correct, it is obvious that myriads of human lives 
have been sacrificed by not acting in accordance with 
them, — and that it is to the advice and influence of the 
non-contagionists this immense sacrifice must be charged. 
The non-contagionists having had the field almost ex- 
clusively to themselves for thirty-seven years, and not 
having been able, during that long period, to effect any 
good,- — either by enlightening the public mind respecting 
the cause of this pestilence, or by suggesting any mea- 
sures that could check its ravages, — it is due to hu- 
manity, and to a common sense of self-preservation, 
that the doctrine and views of the contagionists should 
now be fully and fairly tested. The only general mea- 



XIV PREFACE. 

sures which the non-contagionists ever suggested, to 
arrest the progress of cholera, were cleanliness and fumi- 
gations; — and an experience of thirty-seven years has 
clearly demonstrated, in every part of the world, the 
total inefficacy of these measures. There are but few 
localities, of the many thousands which cholera has 
visited, where cleanliness and fumigations have not been 
resorted to as preventive measures, — and it would be 
hazarding but little to assert, that not one well estab- 
lished instance can be shown, out of those many thou- 
sands of experiments, in which these measures proved 
efficacious. And yet these are the measures, and the 
sole measures, which the non-contagionists still persist 
in recommending, to stop the march, and check the 
ravages of cholera ! The invariable failure of those 
measures, wherever they have been trusted to, during 
thirty-seven years, seems to have caused no discourage- 
ment to them ! — As soon as the disease approaches a 
city, they raise the cry of cleanliness ! cleanliness ! and, 
in the face of all experience, still delude the citizens 
with the vain hope, that if the city be projDerly cleansed, 
the pestilence will be greatly checked, if not entirely 
controlled, in its ravages ! The Chinese were not more 
deluded, when the}^ undertook to repel British invasion 
by the exhibition of ridiculous gymnastics and hideous 
sounds — a mode of defence which their experience has 
probably taught them not to repeat. Cleanliness is very 



PREFACE. XV 

beneficial in itself; but, if we may judge from many 
thousands of experiments, it is just as ineffectual a shield 
against the assault of cholera, as gymnastics are against 
British cannon. 

The measures which the contagionists have always 
recommended, and which they still recommend, are 
widely different from those which have been so long, so 
extensively, and so fruitlessly employed by their antago- 
nists. They are indeed the only measures that now offer 
any hope of success : if they fail, all human efforts to 
resist the spread of this pestilence will be in vain, and 
our sole reliance must be on the mercy of Providence. 
But that they will not fail, and that, when generally and 
judiciously employed, they will greatly restrict, if not 
entirely control the ravages of this disease, we find 
ample assurance in the manifest success which has, in 
many instances, attended their partial adoption. 

In republishing this Essay, I do not consider it neces- 
sary to add any of the many thousands of new facts, 
which can be adduced to prove the contagiousness of 
cholera. My reason for not doing so, is this : — I have 
already published in this Essay, twenty-one facts of a 
positive, undisputed, and unequivocal character ; and it 
appears to me, that the mind which cannot be convinced 
by these twenty-one facts, cannot be convinced, were I 
to present to it twenty-one thousand facts of a similar 
character. 



XVI PREFACE. 

As early as 1832, I became, on reading the history of 
cholera in India, a decided believer in its contagiousness. 
Since then, I have never entertained a doubt on this 
subject ; for, besides my own personal observations, the 
subsequent history of the disease, has presented, at almost 
every step of its progress, what has appeared to me con- 
clusive evidence in confirmation of this belief. It was 
the firm conviction which I felt of its contagiousness, 
and the vast benefit which I conceived would result to 
mankind if this truth were generally known, that in- 
duced me, at the commencement of my professional 
career, to oppose the great body of the medical profes- 
sion on this important question. I had much reason to 
be gratified at the kind and tolerant reception which the 
first edition of this little Essay met with, even by those 
of my professional brethren whose views on the subject 
were entirely different from my own. I have, for many 
years, been urged by professional friends to republish 
this book, and would have done so long since, had not 
the accidents of army-life prevented it. In republishing 
it now, I am impelled by the same motive which caused 
its first publication, viz : to give my humble aid in the 
promulgation of a truth, the knowledge of which I con- 
ceive to be of vast importance to mankind, 

Fort Vancouver, Washington Territory, 
September 21st, 1854. 



PREFACE 

TO THE FIRST EDITION 



Whatevek judgment may be passed, by the profession 
and the public, on the doctrine advanced in the following 
pages, and the arguments used to sustain it, I feel as- 
sured that an effort to develop truth, uninfluenced by the 
fears of the timid, or the authority of names, must meet 
the approbation of the enlightened and liberal ; even 
among those who may arrive at different conclusions 
from myself. The age is passed when the truth, either 
in law or physics, might be held a libel. It is an ad- 
mitted maxim in philosophy, that the knowledge of truth 
is always advantageous, and that error is always baneful. 
But how often do we hear it asserted, even among mem- 
bers of the medical profession, that the truth ought not 
to be told; that even if the contagious character of cholera 
were certain, it ought to be kept a secret from the public, 
lest the knowledge of the fact might have an evil ten- 
dency ! To attempt, at the present day, to refute such 
doctrine is superfluous. The intelligence of the age re- 
volts at it. Every inquiry into the laws of the moral 
and physical world, must now be judged by the advances 

B 



18 PREFACE. 

it makes in the discovery of truth ; not as to the expe- 
diency of promulgating it. 

If the fatal career of this disease is ever to be arrested 
by human means, it will surely be accomplished by our 
becoming acquainted with its character, and the laws by 
which it is governed. And this knowledge must be at- 
tained by a rigid scrutiny of the facts presented in its 
history, and by fearless and open discussion. 

Whether cholera be contagious, or in other words, 
whether it be communicable from one human body to 
another, is indeed an inquiry of great moment ; and one 
which ought not to be decided by weight of authority, 
nor by appeals to popular prejudice. It is a question 
the importance of which entitles it to the most dispas- 
sionate investigation; for its influence extends not 
merely to a city, a kingdom, or a continent, but to the 
whole family of mankind. It becomes us, therefore, to 
approach it, not in the spirit of angry and intolerant dis- 
putants, whose paltry ambition is the triumph of an 
hour ; but in that temperate spirit of forbearance which 
ever characterizes the sincere votaries of truth. 

The following pages were written with the design of 
placing before the public an impartial view of the facts 
and reasonings on both sides of this question ; comprised 
in a small volume, divested as much as possible of tech- 
nical phraseology, and unincumbered by contradictory 
and equivocal statements. Such a work, at this time, I 



PREFACE. 19 

conceive to be a desideratum, to enable intelligent men 
of all professions and occupations to make their own de- 
ductions, and form their own opinions, on a subject which 
so nearly concerns them. 

It was suggested by some of my friends, that a brief 
outline of the most approved mode of treatment of cho- 
lera, such as might be adopted before medical aid could 
be obtained, would be found useful ; especially to those 
residing in the country. I have yielded to this sugges- 
tion, but must accompany it with the most emphatic 
warning that its adoption should in no degree retard the 
obtaining of professional assistance. 



CONTAGION IN GENERAL. 



It may be well, perhaps, before entering on the ques- 
tion whether cholera be contagious, to make a few ob- 
servations on the subject of contagion in general. So 
much has been said about the " laws of contagion," and 
the " laws of epidemics," that many persons are led to 
suppose not only that contagious and epidemic diseases 
are known to be distinct, but that each is characterized 
by well established laws. Such, however, are not the 
facts : there is no distinction, except a hypothetic one, 
between contagious and epidemic diseases ; nor is there 
more than one general law by which contagious diseases 
may be characterized. 

Indeed, the words contagion, infection, epidemic, and 
endemic, are so variously applied, and so often con- 
founded, even by medical writers, that in order to be 
clearly understood on this subject, it becomes necessary 
for each one to define the exact import of the terms he 
employs. To arrive at the best application of those 
terms, it is neither necessary that we should refer to the 
folios of antiquity, with a view to discover their original 
signification, nor that we should be restricted, by the 
conventional law of common acceptation, to their present 



22 CONTAGION IN GENERAL. 

import. Words being but the representatives of ideas, 
must necessarily change as science advances ; so that it 
is the present, and not the past state of knowledge, that 
must define our terms. 

All diseases may be divided into two classes ; specific 
and accidental: specific, those which have a poison for 
their remote cause ; accidental, such as result from any 
cause (except a poison) which disturbs the balance of 
health. My remarks here shall be confined to specific 
diseases, as they only have relation to the subject. 

The class of specific diseases may, as regards etiology, 
be divided into two orders : progressive and local; pro- 
gressive diseases have animal poisons for their remote 
cause, and are all contagious ; or, in other words, are 
communicable, either mediately or immediately, from 
one human body to another. The poisons which pro- 
duce progressive diseases are very numerous, and for 
the most part intangible. Of their origin, and essential 
nature, we are entirely ignorant ; for no chemical test 
can reach them, and it is only by their effects that we 
are apprized of their existence. Each one of them is 
specified by its own distinct laws ; and there is no law 
common to all of them, except that of communicability . 
Even this law is so modified in each disease, that there 
are no two in which it acts precisely alike. In some it 
is necessary, in order to communicate the poison, that it 
should be brought into immediate contact with the body ; 
while in others it may be communicated to a consider- 
able distance through the atmosphere. Syphilis, herpes, 
gonorrhea and itch, afford examples of the former ; 



CONTAGION IN GENERAL. 23 

small-pox, measles, hooping-cough and mumps, of the 
latter. But it is not merely as regards the distance 
through which these poisons are communicable that this 
law differs ; it differs also as regards the power of com- 
municability. Some of them will affect almost every 
individual that comes within the sphere of their influ- 
ence, while others are extremely limited in their action. 
For instance, small-pox spares but few, while mumps 
affects but few. There are, in short, as great differences 
both in the manner and degree in which contagious dis- 
eases are communicated, as there are differences in the 
volatility and intensity of their respective poisons. 

The rapidity and extent of their progress are also 
various, and may be modified by several circumstances : 
by the degree of volatility and communicability of their 
poisons, by the facility and extent of human intercourse, 
by climate, season, &c. When circumstances concur to 
favor the general and rapid spread of any disease, it be- 
comes, ipso facto, an epidemic ; and it is strictly in this 
sense, and not as applied to any particular class of dis- 
eases, that I shall employ that term. Small-pox, from 
its great power of communicability, generally prevailed 
as an epidemic, before vaccination arrested its march; 
measles and scarlatina are still epidemic, when circum- 
stances favor their progress; while mumps, from its 
very low power of communicability, never has been, and 
never can be epidemic. Local diseases, such as bilious, 
remittent and intermittent fever, are generally epidemic 
in the fall, that being the season when vegetable decom- 
position is most favorable to their production. 



24 CONTAGION IN GENERAL. 

The term epidemic has been very generally confined 
in its application to such diseases as are supposed to de- 
pend on some morbid constitution of the atmosphere ; 
but for this restriction there is no good reason, especially 
as no such constitution ,of the atmosphere has yet been 
proved to exist. The word epidemic signifies literally, 
upon the people, and, if not perverted in its meaning, 
should be made to apply to all such diseases as prevail 
extensively among the people, whether they have their 
origin in the air, from the earth, or in the human body. 
When a contagious disease prevails extensively among 
the people, we may term it a contagious epidemic; when 
a local disease prevails, it may be called a local or non- 
contagious epidemic ; and should we ever discover an 
atmospheric disease, we might call that an atmospheric 
epidemic. 

Of that imaginary constitution of the atmosphere, to 
which the term epidemic has been so generally applied, 
we are in all respects entirely ignorant ; and if such a 
state exist at all, it must certainly exist in opposition to 
those atmospheric laws with which we are acquainted. 
That there are certain conditions of the atmosphere de- 
pendent on thermometrical, hygrometrical, barometrical, 
and electrical changes, which, by debilitating the general 
system, or destroying the balance of its functions, may 
render the body peculiarly susceptible of specific poisons, 
is what few will venture to deny : but that there is an 
" epidemic constitution of the atmosphere," which is, of 
itself, able to produce a specific disease, we have not the 






CONTAGION IN GENERAL. 25 

slightest evidence to show.* It is indeed a mere dogma, 
which, under the sanction of high authority, has been 
handed down from age to age, without being either 
questioned or understood : and when we come to ex- 
amine its merits, and find that it is as gratuitous as it is 
unintelligible, we are at a loss to conceive how, in the 
present age of inductive philosophy, it comes to be re- 
ceived as an undoubted truth. That men, when unable 
to explain the progressive phenomena of disease, should 
have resorted to some unknown cause in the atmosphere, 
to screen them from their own ignorance, is not to be 
wondered at; but that others should afterwards have 
come to view this " airy vision" as a substantial exist- 
ence, is matter of much surprise. 

Those local diseases which sometimes prevail as epi- 
demics, and to which the term endemicf is generally 
applied, are occasioned by certain poisons generated on 
the surface of the earth, and diffused to a limited extent 
through the atmosphere. These, like the poisons of 

* Great quantities of insects, unusual weather, the departure of birds, 
" fevers of extraordinary malignancy," and a great many other accidental cir- 
cumstances which occurred in some places where pestilence prevailed, are each 
and all recorded by different authors, as precursors on which epidemics de- 
pend. Such indeed are the facts upon which the whole fabric of " atmo- 
spheric epidemics" is built. There is not one general fact in support of the 
dogma — and as to those partial ones, they can be adduced with much greater 
force, because with infinitely greater frequency, as the precursors of health ! 

One of the imaginary laws of epidemics is, that no two of them can prevail 
at the same time, and in the same place ; yet the cholera and the yellow fever 
prevailed together for weeks, both in New Orleans and Tampico ; and with 
such equal violence that it was difficult to decide which maintained the mas- 
tery ! Which of these diseases was " the epidemic ?" 

t The term endemic I shall totally discard, as being calculated to cause 
confusion. Whenever I wish to designate an extensive prevalence of a local 
disease, I shall do so by calling it a local epidemic. 



26 CONTAGION IN GENERAL. 

contagion, are not appreciable by any chemical test ; and 
we are therefore entirely ignorant of their constitution. 
They are supposed, however, with much reason, to re- 
sult from some play of chemical affinities produced by 
the decomposition of vegetable matter; and this will 
explain to us why it is that they are confined to par- 
ticular districts, and prevail at particular seasons. The 
distance to which those poisons, or, as they are termed, 
miasmata, will spread beyond the sphere of their origin, 
depends on various circumstances : the quantity of poi- 
son generated, and its diffusibility ; the condition of the 
atmosphere, the force of the winds, &c. Under no cir- 
cumstances, however, is this distance very : great, if we 
may judge from intermittent and bilious fevers, which 
scarcely ever extend a mile from the place of their sup- 
posed origin. 

The most obvious distinction between local and con- 
tagious diseases is, that the former are only to be found 
in certain locations, and certain seasons ; while the latter 
may, for the most part, be met with under all possible 
circumstances of climate and locality. Intermittent and 
bilious fevers are always limited to certain districts, and 
to certain seasons ; because their poisons, being gene- 
rated on the surface of the earth, require a concurrence 
of chemical causes for their production : while small-pox, 
measles, and all other contagious diseases, deriving their 
poisons from the human body, are in a great measure 
independent of climate and locality. Man is at once 
their victim and their propagator, and so far as his in- 
tercourse extends, their travels extend also. 



NON-CONT AGIONISTS . 27 

Whenever, therefore, we see a disease go abroad from 
the place of its origin, we have a prima facie evidence 
of its contagiousness ; — for, in the present state of our 
knowledge, there is no other mode than that of human 
intercourse, by which the progress of any disease can be 
accounted for. 

It will be perceived from the foregoing remarks: first, 
that progressive and contagious diseases are considered 
as synonymous : secondly, that by the term contagious, 
are designated all diseases which owe their existence to 
animal poisons ; whether those poisons be communicated 
by actual contact, or through an indefinite extent of 
atmosphere :* thirdly, that by the word epidemic is sig- 
nified no particular class of diseases, but the extensive 
prevalence of any disease : and, fourthly, that local dis- 
eases are not contagious, and therefore are limited to 
particular districts. 



OF THE CONTAGION OF CHOLERA. 

It is admitted by all, that cholera has, within the last 
few years, made its appearance in many thousands of 
places where it had never appeared before : and it is 
very evident that it must have visited those different 
places by progression — or else it must have originated 
in each place where it has appeared. If it visited them 

* I can see no necessity whatever for the word " infectious ;" on the con- 
trary^ having been so variously applied, and so often confounded, it has be- 
come worse than useless ; I shall therefore discard it altogether. 



28 HYPOTHESES OF THE 

by progression, there are but two* modes in which it 
could possibly have done so. One is, through the me- 
dium of the atmosphere, the other, by means of human 
intercourse. If it originated in each of the many thou- 
sands of places where it has appeared, it must have been 
caused by emanations arising from the earth, or else by 
some local change in the constitution of the atmosphere. 
Under one or the other of these four general heads, viz : 
progressive atmospheric influence, local atmospheric 
influence, terrestrial emanations, and human intercourse, 
may be embraced, then, all the various hypotheses that 
have been, or ever can be invented to explain the diffu- 
sion of cholera: and if, on inquiry, it shall appear evi- 
dent that this disease does not diffuse itself by any of 
the three former modes, we shall then have it negatively 
established that the last, or that of human intercourse, is 
the mode by which it does advance. I now proceed to 
the consideration of each of those different heads in the 
order in which they stand. 



PROGRESSIVE ATMOSPHERIC INFLUENCE. 

If we suppose cholera to depend upon some occult 
poison, which either propagates itself, or is itself propa- 
gated by means of the atmosphere, we must suppose, 
also, that the progress of that poison will be hastened or 
retarded by the same causes that hasten or retard the 

* The idea that it might have proceeded through the earth, so as to have 
passed beneath the Indian and Atlantic oceans, is too absurd to merit formal 
refutation. 



NON-CONTAGIONISTS. 29 

progress of atmospheric air : and this will be equally 
true, whether the atmosphere be merely the vehicle of 
some extraneous poison, or whether it have itself under- 
gone some morbid change. We find, however, that the 
progress of cholera is totally uninfluenced by any such 
causes. The most powerful monsoon winds can neither 
accelerate nor retard its march ; nor is there any variety 
of temperature, or any atmospheric circumstance what- 
ever, between twenty degrees south and sixty-five north, 
which has been able to extinguish it, or even to modify 
its character. 

It travelled from the sources of the Nerbudda into 
Bombay, in the teeth of a wind which prevails six 
months, night and day, with rather more rapidity than 
it did from Madras to Cape Comorin, where a similar 
wind was in its favor. * It has proved itself as violent 
in Russia as in the Mauritius — in Canada as in India. 
In short, it has presented itself to us in every clime, and 
under every conceivable circumstance of atmosphere, 
with all the frightful features that mark its individuality ; 
so that if it have at any time appeared modified in its 
character, such modification can only be attributed to 
the different susceptibilities of its victims. Were the 
fact denied, innumerable proofs might be adduced to 
show that cholera has, in its progress, paid not the least 
regard to any atmospheric laws with which we are ac- 
quainted. If this disease then propagate itself by means 
of the atmosphere, and yet be independent of all atmo- 
spheric laws, it is reasonable to suppose that, by virtue 

* Orton, p. 336, second edition. 



30 HYPOTHESES OF THE 

of such independence, it would be able to advance with 
uniform and unimpeded rapidity. — Such, however, is by 
no means the case. Nothing can vary more than the 
degrees of rapidity with which cholera travels, at differ- 
ent times, and in different places. It sometimes travels 
farther in a day than it will at other times in a month ; 
and generally passes over water with much greater 
rapidity than it does over land. From its origin, at 
Jessore, it radiated as from a centre to a circumference, 
travelling north, south, east* and west, with various 
degrees of rapidity, until it reached the confines of Asia, 
in every direction. As early as the year 1820 it visited 
Canton, situated on the border of the Pacific, and had it 
travelled over that ocean, with the same rapidity with 
which it crossed the Atlantic, it must have reached our 
North Western Coast in 1822, and have visited Balti- 
more eight or nine years ago ; not as an eastern, but as 
a western pestilence. But it is now 1833, and the dis- 
ease has not yet crossed the Pacific ! Why, then, I ask, 
has it not crossed the Pacific ? It has crossed all Asia, 
all Europe, the Atlantic ocean, and the greater part of 
North America ; and yet, strange to say, it has not yet 
crossed the Pacific, although it reached its coast thirteen 
years ago ! On what atmospheric principles can this 
question be answered 1 It can be answered on no prin- 
ciples except those of contagion. The poison of cholera, 
owing to its great volatility, soon becomes extinct, and 



* It is supposed by many unacquainted with the history of Cholera, that it 
always travels westward. It took but three years, however, to reach Canton, 
which lies 1500 miles east of Jessore. 



N0N-C0NTAGI0NISTS. 31 

this renders it exceedingly difficult to convey it to any 
great distance, unless it can be regenerated by new vic- 
tims. Hence we find that, notwithstanding the exten- 
sive intercourse between Europe and North America, 
there never were but three* vessels suspected of having 
conveyed this poison across the Atlantic ; and those were 
so crowded with emigrants, as to have afforded the dis- 
ease the best opportunity of surviving so long a passage. 
What chance then could there be for conveying this 
poison over an ocean ten thousand miles wide, across 
which there is little or no intercourse, and no emigration 
whatever ?f 

It is also worthy of remark, that this disease has 
never been able to cross extensive deserts, although the 
loftiest mountains presented no obstacle to its progress. 
The deserts of Baloochistan and Chaboul were insur- 
mountable barriers to it, while the Himalaya mountains, 
17,000 feet high, did not even check its march. J 

* The brigs Oarrick and Royalist, at Quebec, and the ship Brenda, at Balti- 
more. Upwards of thirty -three thousand passengers arrived at Quebec alone, 
during that season, and yet there were but two vessels on board which any 
persons had died of cholera ! 

f It is now (1854) thirty-four years since the cholera first reached Canton, 
and jet it has never crossed the atmosphere of the Pacific to this day — 
although since immigration has become very extensive, it generally crosses 
that of the Atlantic several times a year ! This is certainly another profound 
non-contagion " mystery !" 

X Although cholera has repeatedly accompanied, for a few hundred miles, 
the emigrant trains which annually cross the desert plains on their way to 
California and Oregon, it has never yet continued among them till they reached 
their destination; and has, consequently, never been introduced by them into 
either of these countries. If cholera be caused by "a general atmospheric 
influence," why did not this influence continue on to California and Oregon, 
after having affected all the emigrants that were susceptible of it ? If it were 



/ 



32 HYPOTHESES OF THE 

Another objection to a general atmospheric influence, 
may be found in the irregularity with which cholera ad- 
vances. This disease has never been known to pass 
over the whole face of a kingdom or a continent, with 
that unbroken sweep, which must necessarily have cha- 
racterized any general atmospheric intemperament. On 
the contrary, its march seems to have been uniformly 
guided by the routes of human intercourse ; and has 
always been as devious and as whimsical as such inter- 
course might be supposed to have rendered it. It is 
only necessary to glance at the history of the disease, 
since its arrival on our own shores, in order to convince 
ourselves that its main routes are always the great high- 
ways of intercourse. Every step it has taken, from 
Quebec to Chicago, from Detroit to New Orleans, and 
from Montreal to Baltimore, is in confirmation of this 
fact. 

It is well known that in Canada the great tide of 
emigration flows from Quebec to Montreal, and that at 
Montreal it divides into two currents : the one running 
westward along the great lakes to Detroit, the other 
southward, by the way of Albany, New York, Philadel- 
phia and Baltimore. Accordingly, we find that these 



a local disease, what imaginable cause could be assigned for its having found 
so many localities within the first few hundred miles, and not one locality 
within the last 1500 miles of the journey ? Is it not " mysterious" too that 
this pestilence should frequently occur in the proverbially pure air of those 
desert plains — and never occur, except by some intelligible accident, in any 
of the most unhealthy country parts of the United States ! Ought not this 
single fact of itself, when duly considered, open eyes that have been closed for 
thirty-seven years ? 



NON-CONTAGIONISTS. 33 

were the great routes by which cholera advanced. In 
about two days after its arrival in Quebec, it reached 
Montreal; leaving the whole district of intermediate 
country untouched. It then proceeded westward and 
southward. In its western route, it travelled with great 
rapidity, visiting in quick succession the principal towns 
along the lakes ; and accompanying the United States 
troops in their march from Buffalo to Detroit, from De- 
troit to Chicago, and from Chicago to St. Louis. It 
likewise followed the current of emigration into Ohio, 
and visited the principal towns in that State ; leaving 
Pennsylvania behind it. After having reached Cin- 
cinnati, it travelled with unparalleled rapidity, down the 
waters of the Ohio and Mississippi, till it arrived at New 
Orleans ; leaving behind it many towns which it after- 
wards visited. 

In its southern, as well as in its western route, it 
moved steadily along the great highways of intercourse ; 
first visiting the large cities, then radiating among the 
smaller towns and villages, but never diffusing itself 
among the country houses. From Montreal it travelled 
to Albany in a few days, and reached New York about 
the same time ; leaving in its rear, totally untouched, 
all the New England States, and nearly the whole of the 
vast State of New York. After having reached New 
York, it visited, in pretty quick succession, Philadelphia, 
Baltimore, Washington and Richmond ; leaving many of 
the inland towns of Pennsylvania, Maryland and Vir- 
ginia unaffected. It visited a few places in North 
c 



34 HYPOTHESES OF THE 

Carolina, and having advanced as far as Folly Island, it 
there terminated its southern tour.* 

Such is a brief outline of the progress of cholera over 
the bosom of our own country ; and it will be perceived 
that in it, as in all other countries, the great channels of 
human intercourse were the main routes by which it 
advanced. Its movements were indeed like those of an 
invading army : having once obtained a foothold on our 
shores, it next advanced, by forced marches, on our prin- 
cipal cities; and having ravaged them, sent detachments 
in all directions to attack the smaller places in detail. 

And now let me ask, by what atmospheric laws, 
either real or imaginary, shall we be able to explain 
these facts? Is it not entirely inconceivable how any 
atmospheric cause, so general as to have traversed two- 

* In all its subsequent travels in the United States, which have been very 
extensive, cholera has exhibited the same characteristics that it did on its first 
visitation, in 1832. The great routes of human intercourse have uniformly- 
been the main lines by which it h&sjirst diffused itself. The Mississippi river 
has been always its greatest thoroughfare — next, the Ohio river, and then 
other navigable rivers, in a degree generally commensurate with the amount 
of travel that prevails on them. It has occurred on several occasions since 
1833, that nearly every town bordering on the Mississippi, between St. Louis 
and New Orleans, was ravaged by this disease, at the same time that the inland 
towns, villages, country residences and innavigable rivers — as far east as the 
.Atlantic, and as far west as the Pacific — were almost entirely exempt from it. 
It is now upwards of twenty years since the cholera first visited the United 
States, and yet a single case of it has never occurred in any part of East Flo- 
rida, which is 400 miles long, and 150 miles wide ! What an impenetrable 
" mystery" must this be to the non-contagionists ! The contagionists, how- 
ever, find no difficulty in revealing it, simply by stating the fact that the Penin- 
sula of Florida lies south of all the main lines of travel, and has hitherto had 
comparatively but little intercourse with the more populous portions of the 
Union. It has escaped this pestilence for the same reason that Oregon has 
escaped it, and that about ninety-nine out of every hundred country houses 
on the continent of North America, have escaped it. 



NON-CONTAGIONISTS. 35 

thirds of the habitable globe, should yet be so partial as 
to choose particular routes, and to overstep particular 
districts? But even admitting it possible, that any atmo- 
spheric influence could, at one and the same time, be so 
general and so partial, would it not still be a mystery 
that this partiality should be so uniformly directed to 
the thoroughfares of men? Why, for example, should 
this atmospheric poison have advanced with so much 
greater rapidity in the routes to Baltimore and Detroit, 
than in any other direction? Was it because it could 
find no victims in the direct course, through the states 
of New England, that it chose the circuitous route by 
Albany? Was it not just as likely to have advanced 
along thousands of other different lines, as those along 
which it did advance — and if so, is it not wonderful that 
it should have chanced to travel along the only two in 
which the intercourse was great? Was it not just as 
likely to have pervaded the country, as to have visited 
the towns ; yet who will assert that it did so? Although 
it may now be said to have made the grand circuit of 
North America, having travelled from Quebec to New 
Orleans, and from Baltimore to St. Louis, I will venture 
to assert, that in all the vast regions through which this 
pestilence has passed, there is not a single county to be 
found over which it has prevailed as an epidemic* 



* Cholera has sometimes made dreadful devastations in the country ; but 
always in so partial a manner as to preclude the idea that it depended on what 
is termed " an epidemic state of the atmosphere." 

It has frequently swept ten or twenty persons off a single plantation, while 
all the circumjacent plantations, although similarly circumstanced, have en- 
tirely escaped. 



36 HYPOTHESES OF THE 

The few cases that occurred in the country parts of the 
state of Maryland were traced, (so far as my information 
extends,) in almost every instance, to infected places; and 
were never known to extend beyond the immediate circle 
of attendants.* What atmospheric cause can be assigned, 
then, for this undisputed fact? Will it be said that the 
pure air of the country was able to modify, or neutralize 
this atmospheric poison? Why, then, were the pure 
and impure parts of the country equally favored by it? 
Why were the marshy districts of the Eastern Shore 
just as free from cholera as the healthy highlands of 
Frederick county? Why was the disease just as malig- 
nant, wherever it did appear in the country, as it was in 
the filthiest parts of the filthiest cities? Why was it not 
modified or neutralized by the pure sea breezes, that 
wafted the ship Brutus over the ocean wave, when one 
hundred and seventeen of her passengers were attacked, 
and seventy-nine cut off, in the short space of ten days ? 

I might, did I conceive it at all necessary, multiply 
facts and arguments on this subject ; but what I have 
already stated will, I trust, be sufficient to satisfy every 
unbiassed mind, that the hypothesis of a progressive 
atmospheric influence is utterly untenable. It is not 
only a baseless assumption, without either fact or 
analogy to sustain it — but it is an assumption to which 
a multitude of well established facts are directly op- 
posed. 



* I do not, of course, include those cases which occurred on our rail-roads, 
canals, and other public works, where the disease was so generally de- 
structive. 



NON-CONTAGIONISTS. 37 



LOCAL ATMOSPHERIC INFLUENCE. 

The facts presented in the progress of cholera, having 
been found totally irreconcilable with the assumption of 
a progressive atmospheric influence, it became necessary 
for the non-contagionists, either to contend for the local 
origin of this disease, or else abandon all speculations on 
the subject, and acknowledge their entire ignorance of 
its mode of diffusion. 

Many of them adopt the latter course, and admit, 
with no less modesty than candor, that although the 
disease has now formed a chain of twelve thousand miles 
in extent, they are entirely ignorant of the manner in 
which a single link has been formed. 

Others, however, pertinaciously contend for its local 
origin; and undertake, by a variety of hypotheses, to 
account for its appearance. 

One of these sects assumes some local change in the 
constitution of the atmosphere, which is said to occur in 
the thousands of places where cholera appears. But 
even this sect is greatly divided in opinion as to what 
that change is : some attributing it to " a certain elec- 
trical condition ;" others to clouds of animalculse ; others 
to some modification in the rays of light ; and others to 
something else equally gratuitous and unintelligible. 
Unfortunately for all these hypotheses, the poison of 
cholera has manifested itself under every conceivable 
circumstance of atmosphere, without any appreciable 



38 



HYPOTHESES OF THE 



difference in its malignancy. It is true, it has prevailed 
extensively in some places during the occurrence of ex- 
cessive rains ; but then, it has prevailed in others during 
periods of excessive drought. In some places, its ravages 
have been accompanied with unusual heat ; in others, 
with unusual cold. Large quantities of insects have 
sometimes accompanied it; at other times they have 
not. Indeed, it must appear evident to every one, at 
all familiar with the history of cholera, that those cir- 
cumstances, set down as being necessarily connected 
with its production, have been merely accidental con- 
comitants — such circumstances as every day occur in 
places where cholera does not appear, and such circum- 
stances as have been occurring for centuries past, with- 
out producing the disease. 



TERRESTRIAL EMANATIONS. 

Did cholera depend on emanations from the surface of 
the earth, it is impossible to conceive how those emana- 
tions should be precisely the same under every variety 
of climate and locality. Being generated on the surface 
of the earth, they must owe their formation to some? 
play of chemical causes ; and must consequently be in- 
fluenced, more or less, by every chemical circumstance. 
We could not, then, expect to find the same chemical 
result in the snows of Russia as in the sands of Arabia ; 
nor on the tops of the Himalaya mountains, as in the 



NON-CONTAGIONISTS. 39 

marshes of the Ganges ; and yet cholera has been pre- 
cisely the same in those, as well as in all other places. 
Besides, if the same result can be produced in all places, 
and under such opposite circumstances, why is it not 
also produced at all times? why should a chemical effect, 
so common as to have occurred in thousands of places, 
during a single year, never have happened, even once, 
during so many centuries before? 

Some contend that the poison is generated in the 
bowels of the earth : but this hypothesis is as gratuitous 
and as untenable as the last ; and the same arguments 
that refute the one, apply with equal force against the 
other. 

An answer to all speculations on the local origin of 
this disease, may be found in the fact that it has tra- 
velled from Jessore to Moscow, from Moscow to Quebec, 
and from Quebec to New Orleans, by one continuous chain 
of posts; thus rendering it impossible that it could have 
depended on local origin of any kind. If cholera de- 
pended on local origin, its appearance in one place, could 
have had no necessary connection with its appearance in 
another : — it was as likely, for example, after it broke 
out in Quebec, to have next shown itself in Cincinnati, 
or in Buenos Ayres, as it was to have appeared in 
Montreal, or Albany ; but we find that instead of occur- 
ring unconnectedly in different places, it formed, link 
after link, an unbroken chain of more than twelve 
thousand miles in extent ; and thus proved to demonstra- 
tion, that it is a progressive, and not a local disease. 

Cholera then is a progressive disease, and has been 



40 EVIDENCES OF CONTAGION. 

already proved not to travel through the atmosphere.* 
How then does it travel? There is but one way left ; — 
and that is by means of human intercourse. 

Having now, I trust, established, by negative proof, 
that cholera is contagious, I next proceed to the con- 
sideration of such general facts as will afford positive 
evidence of the same truth. 



HUMAN INTERCOURSE. 

When we reflect on the utter impossibility of recon- 
ciling the progress of cholera, with any one of the many 
hypotheses which the non-contagionists have devised, 
we cannot be surprised that they should have exclaimed : 
" Its march is a mystery, and its ways are inscrutable !" 
To them it is indeed a mystery; — for although it has 
now been sixteen years travelling, and has, in that time, 
pervaded three continents, and crossed two oceans, they 
are still unable even to imagine how one step of this 
vast journey has been accomplished ! To the mind of 
the contagionist, however, the progressive phenomena of 
this disease present but little mystery ; its movements 
are, to him, at least as intelligible as those of scarlatina 
or measles ; and if he be not able to trace it through all 

* Although cholera has now (1854) been thirty-seven years travelling, the 
non-contagionists are just as ignorant of its mode of progress, at this time, as 
they were in 1817, when it first made its appearance in Jessore ! Is there any 
hope that they will ever shed light on this subject ? 



EVIDENCES OF CONTAGION. 41 

the secret windings of its invisible march, he is never- 
theless convinced, that he knows the mode of its pro- 
gress. In order to explain this progress, and to divest 
the subject of nearly all its mystery, he assumes but 
three propositions ; each one having innumerable facts 
to establish its truth. 

First : that the poison of cholera is communicable from 
one human body to another. 

Secondly : that it is extremely subtile and diffusible in 
its nature. 

Thirdly : that, in a large majority of cases, it is inca- 
pable of developing disease, unless assisted by an exciting 
cause. 

Of the cause, or causes, that first gave rise to cholera 
we know nothing; nor is it probable that we ever shall. 
In this respect, however, we are no more ignorant, in 
relation to it, than we are to many other diseases. Of 
the origin of small-pox, measles, scarlatina, and other 
specific poisons, we are equally ignorant ; for, being in- 
scrutable in their nature, it is only by their effects that 
they are at all appreciable. But however ignorant we 
may be of the circumstances that first produced the 
poison of cholera, it is very certain that, when once pro- 
duced, it possessed the power of reproduction. The 
truth of this must be obvious to all: for, whether we 
view this poison as residing in the atmosphere, the 
earth, or the human body, it is equally impossible to 
conceive that that quantity which was first generated at 
Jessore could have been diffused over three continents, 
and yet every where have maintained its original inten- 



42 EVIDENCES OF CONTAGION. 

sity. The question then arises, where is this poison 
reproduced : in the atmosphere, the earth, or the human 
body? For neither of the two former sources have we 
any known prototype ; for the last we have many : — we 
do not know of any poison which reproduces itself either 
in the atmosphere or in the earth ; but we do know of 
many which reproduce themselves in the human body. 
The rational inference then is, that the poison of cholera 
also reproduces itself in the human body: and this in- 
ference must stand unshaken, unless there be, in favor 
of atmospheric or terrestrial reproduction, direct evi- 
dence which is stronger than that in favor of reproduc- 
tion in the human body. But having already made it 
appear that there is no evidence whatever in favor of 
either of the former, it now only remains to produce 
some positive facts in support of the latter, in order to 
demonstrate its truth. 

The positive facts in favor of the contagiousness of 
cholera may be considered under two heads — general and 
particular. 



GENERAL FACTS. 

Were I to adduce all the general facts which serve to 
establish the contagiousness of cholera, it would swell 
this little treatise far beyond the limit assigned to it. I 
shall therefore confine myself to the consideration of the 
following five: 



EVIDENCES OF CONTAGION. 43 

1. Its power of progression, 

2. The continuous line of posts by which it travels. 

3. The irregularity of its progress. 

4. The preference which it manifests for those routes in 
which there is the greatest intercourse. 

5. The irregularity of its periods of increase and decline 
in the different places which it visits. 

First: One of the most striking views which cholera 
presents in favor of its contagiousness, is its power of 
progression: for while it is obviously true that all con- 
tagious diseases are progressive, it is by no means 
established that there is any progressive disease which 
is not contagious. We are told that influenza and some 
other progressive diseases are not contagious, and that 
their progress is dependent on an epidemic constitution 
of the atmosphere ; but of the truth of this assertion 
we have no proof. On the contrary, influenza, in com- 
mon with all other progressive diseases, is totally regard- 
less of those atmospheric laws with which we are 
acquainted. Not even the most powerful winds* can 
either hasten or retard its progress ; nor are we able to 
appreciate any atmospheric circumstance whatever, that 
can modify its character. Besides, there are numerous 
facts of a positive nature to prove its contagiousness. f 

2. Were cholera any other than a contagious disease, 
it would be impossible to assign a reason for its visiting 
all the large towns by forced marches, and afterwards 
ravaging in detail the smaller places which it had over- 

* Good's Study Med., vol. ii. p. 294. t Idem, vol. ii. p. 298. 



44 EVIDENCES OF CONTAGION. 

stepped. Yet this is the manner in which it has pro- 
ceeded through every country. For example, having 
arrived in Quebec, it made but one stage to Montreal, 
although there were several intermediate towns which it 
afterwards visited. Now what reason can be assigned 
for this preference to Montreal, over several other places 
which lie nearer to Quebec? Shall we be told that 
Montreal, being a large, populous, and filthy city, 
afforded the best entertainment to this voracious 
stranger? Admitting this to be true, still it will not in 
the least explain the difficulty. Montreal yielded it 
thousands, the intermediate towns yielded it hundreds 
of victims ; why then did it pass the hundreds by, in 
order to seize the thousands — and why did it then turn 
back and seize the hundreds? Besides, if this disease 
visited those places first where it was best entertained, 
it should certainly have visited Havana and New Orleans 
long before it visited Montreal. These facts, which to 
the mind of the non-contagionist are so perfectly inex- 
plicable, present to the contagionist not the slightest 
difficulty. On the contrary, seeing in them nothing 
more than the ordinary manifestations of a contagious 
disease, he views them as so many clear and satisfactory 
evidences of the truth of his doctrine. He can readily 
understand how a contagious poison might have been 
conveyed either by the body or the clothes of a person 
travelling from Quebec to Montreal, without affecting 
in the slightest degree the intermediate towns: and how 
this poison, after it had become generally diffused in 
that large city, might afterwards have been conveyed 



EVIDENCES OF CONTAGION. 45 

to the circumjacent towns, whose intercouse was less 
extensive. 

3. The irregularity with which cholera advances, 
although entirely uninfluenced by the winds, can be 
reconciled with the doctrine of contagion only. This 
irregularity may be marked, not only in its excursive 
and capricious routes, but also in the different degrees 
of rapidity with which it marches. Did cholera move 
over the face of a country with such unbroken regularity 
as to be only influenced by changes of wind, it would 
be a strong fact against the idea of its contagiousness. 
Or did it, on the other hand, present itself only at dis- 
tant and unconnected points, we should still have much 
reason to doubt that its progress depended on human 
intercourse ; for we should have, in the one instance, a 
manifestation of some general vitiation of the atmo- 
sphere, and in the other, a fact in favor of local origin. 
In neither of these modes, however, does the disease 
advance. It advances by distinct steps of various 
length, but all so connected as to form consecutive links 
of innumerable chains, which extend themselves towards 
every point, without observing the least regularity in 
their course. There is nothing which these chains so 
much resemble, both in length and irregularity, as the 
lines of human intercourse:* and if we can only admit 



* Is it not a most striking fact in favor of the contagiousness of cholera, that 
in crossing a sea it always travels in a single line, and that line so narrow as 
to touch but a single city ; whereas, in crossing a continent, it travels in thou- 
sands of lines ? It crossed the Atlantic, for example, in so narrow a line as 
only to have touched Quebec, yet how many lines has it formed, and how 
many cities has it touched in crossing the western continent ? 



46 EVIDENCES OF CONTAGION. 

that cholera may be contagious, we shall find but 
few mysteries to expound in the whole history of its 
progress. But if on the other hand we deny its conta- 
giousness, we shall find a mystery in every step which 
the disease has taken between Jessore and New Orleans. 
Its whole course will indeed present a concatenation of 
mysteries, upon no one of which have the speculations 
of fifteen years shed a ray of light. 

In the irregularity of its speed, it also bears a close 
resemblance to the movements of man: sometimes fast, 
sometimes slow, it travels, in short, at every rate within 
the limit of human speed, but never transcends it. It 
crossed Europe with much greater rapidity than it did 
Asia — so does man. It traversed this continent more 
rapidly than it did Europe — so does man. It took thir- 
teen years to travel from Jessore to Moscow ; two years 
from Moscow to England ; and but one year from Eng- 
land to Chicago ! 

By water it generally travels with much greater 
rapidity than by land — so does man. It crossed the 
Indian ocean to visit Mauritius two years before it 
reached Ispahan, although the latter lies several hundred 
miles nearer to Jessore. It took thirteen years to travel 
from Jessore to Moscow,* a distance of 4,000 miles ; and 
occupied but nine months in crossing the Atlantic, which 
is 3,000 miles wide !f It travelled along the lakes to 

* See Kennedy's Map. 

f The cholera did not reach England till October, 1831 ; and if we even 
suppose that it travelled through the atmosphere, it could not have occupied 
more than nine months in crossing the Atlantic ; as it arrived in Quebec in 
June, 1832. 



EVIDENCES OF CONTAGION. 47 

Detroit with the speed of a marching army; and 
hastened down the Ohio and Mississippi rivers to New 
Orleans with the rapidity of a steam-boat. It is, 
in short, an admitted fact that this disease has, in 
every country, travelled along the course of navigable 
waters with marked rapidity. This I say is an admitted 
fact ; and now let me ask, how the non-contagionists will 
account for it? Will they tell us that its progress is 
favored by the malaria arising from water-courses? If 
so, how happens it that its progress is favored by no 
waters except those which are navigable?* Why is it, 
too, that its progress, instead of being retarded, has been 
very much hastened by the pure air of the Indian and 
Atlantic oceans? Verily, this doctrine of non-contagion 
is one of deep mystery ! The contagionist dispels this 
mystery, however, by simply stating that he who is 
attacked with cholera, while travelling by land, will stop 
at the first stage ; and the disease will be there arrested : 
while he who travels by water will have no stopping 
place short of his destination ; and the disease will con- 
sequently continue to travel with all the speed of a fast 
sailing ship. Indeed, the simple fact that man travels 
more rapidly by water than he does by land, is in itself 
a satisfactory explanation.! 

4. The next, and perhaps the most striking fact in 
favor of its contagiousness, is the preference which cho- 

# There is no instance, in this country, in which cholera has travelled along 
the banks of an unnavigable stream. 

f There is ample evidence to show that since railways have come to form 
the principal lines of communication through the United States, the speed with 
which cholera reaches distant points has been greatly accelerated. 



48 EVIDENCES OF CONTAGION. 

lera manifests for those routes by which there is the 
greatest intercourse. It will be unnecessary, in this 
place, to revert to the history of cholera with a view to 
establish the truth of this fact, as it has been already 
sufficiently considered when treating of the dogma of 
atmospheric influence. It is a fact, indeed, which none 
have ventured to deny, for it is one which strikes the 
observation of every man who pays the least attention 
to the progress of the disease. It is true that cholera 
has sometimes stepped aside from the more populous 
routes, to pursue those in which there was a less degree 
of intercourse:* such deviations as these, however, have 
been exceedingly rare ; and certainly not more frequent 
than we might have anticipated, had we considered the 
many accidental circumstances that may influence its 
progress. But that the great thoroughfares of men are 
the great highways by which cholera advances, is what 
no man, who even glances at its history, will doubt : and 
now, I ask, if this indisputable fact does not afford a 
prima facie evidence that the disease travels by means of 
human intercourse ? What general fact could be stronger 
to prove the truth of this proposition? I know of none. 
This is one of those facts which need not the aid of 
argument — but which speak for themselves, and carry 
with them such intrinsic conviction as no sophistry can 
shake. 

5. The last general fact which I shall notice, is the 



* In those instances where cholera has made excursions of this kind, it has 
seldom proceeded more than one stage before it resumed its original route ; 
thus proving that some accident had diverted it. 



EVIDENCES OF CONTAGION. 49 



irregularity of its periods of increase and decline, in the 
different places which it visits. The diffusion of this 
disease is always gradual, and the time which it takes 
to reach its acme in a place, is generally equal to that 
which it occupies in its decline. This time is much 
longer in large towns than in small ones ; and longer in 
small towns than in camps, jails, alms-houses, and other 
crowded assemblages of men. When cholera enters a 
city, say of a hundred thousand inhabitants, it generally 
commences its ravages in a single house. In two or 
three days it appears in several other houses in and 
about the same neighborhood. To this neighborhood 
its ravages are almost exclusively confined during the 
first six or eight days of its visitation.* After this 
period, however, it begins to show itself simultaneously 
at several different, and sometimes distant points of the 
city, without evidencing the least regard either to topo- 
graphy or cleanliness. These points go on multiplying 
every day, in a geometrical ratio, till at length there is 
scarcely a street or alley in the whole city where several 
have not appeared. After having thus, in about four 
weeks from its incursion, laid a wide foundation for its 
ravages, the work of death goes on with frightful rapidity 

* The ravages of cholera on its first incursion are also very generally con- 
fined to a particular class of people ; sometimes to the highest, but most fre- 
quently to the lowest. This fact seems to depend on the very limited inter- 
course which subsists between the higher and lower grades of society, which 
causes the disease to be confined to that class into which it may have chanced 
to be first introduced. The lower classes are very generally first attacked, 
and for the obvious reason that they form by far the most numerous portion 
of society. As soon, however, as the poison becomes* generally diffused, all 
grades are alike obnoxious to its influence. 
D 



50 EVIDENCES OF CONTAGION. 

till the disease has reached its acme. This generally 
happens about the fifth week ; from which period it be- 
gins gradually to decline, and at the expiration of five 
weeks more is generally extinct. This is the mode in 
which cholera proceeds in the larger cities. In the 
smaller towns (of from three to four thousand inhabit- 
ants) it increases and declines in a similar manner, but 
the period of its duration is much shorter, being seldom 
more than five, or less than two weeks. 

In large bodies of troops, in jails, in alms-houses, and, 
in short, in all condensed crowds of men, this pestilence 
does its work with frightful despatch: sometimes requir- 
ing but eight days to run its whole course, and, in that 
time, sweeping off one-third of the number exposed ! 
In less than eight days twenty thousand persons were 
cut off while celebrating a religious festival on the banks 
of the Ganges ! In the army of the Marquis of Hastings, 
consisting of ninety thousand men, nine thousand fell 
victims in the space of twelve days ! In the Philadel- 
phia jail, although the deaths altogether did not amount 
to sixty, forty-five of them occurred in one day ! It is 
unnecessary to multiply examples of this kind, for every 
one who has paid the least attention to the history of 
cholera must have observed, that it increases and de- 
clines with the greatest rapidity where its victims are 
most crowded. 

Such is the manner in which cholera generally pro- 
ceeds in the different places which it visits. There are, 
however, many circumstances by which its course may 



EVIDENCES OF CONTAGION. 51 

be materially modified.* The season of the year, the 
density of population, the habits of the people, the muni- 
cipal regulations, and various other circumstances may 
have much influence in determining the period of its 
duration, as well as the extent of its ravages. For in- 
stance, in Calcutta, which contains a population of six 
hundred and fifty thousand, it continued its ravages for 
six months ; while in Brussels, and Boston, and several 
other towns where all the sick were promptly removed 
to hospitals — the disease disappeared after a few days. 

It is, indeed, sometimes cut so short in its career as 
not to extend beyond the members of a single family. 
This was the case in its first visit to New Haven, and 
this is almost invariably the case when it visits the 
country. 

A brief review of these facts will enable us to per- 
ceive that contagion is the only doctrine with which 
they can be reconciled : The diffusion of this disease in 
a place is always gradual, and the time it takes to reach 
its acme is generally equal to that which it takes to de- 
cline. Supposing, then, that it depended on the vitiation 
of the whole atmosphere of a city, would its diffusion 
be gradual ? Certainly not. Its influence would be felt 
at once — in every part of that city, and its first sweep 
would, from the greater number of the susceptible, be 
the most mortal part of its career. 

But we are told that this general vitiation may go on 

* Although the poison of cholera is always the same, its ravages may never- 
theless, be indirectly influenced by such circumstances as will tend either to 
increase or diminish the number of the susceptible, and by such conditions of 
the atmosphere as may be more or less favorable to its diffusion. 



52 EVIDENCES OF CONTAGION. 

gradually* increasing in intensity, till it shall have 
reached its highest point of malignancy; and that it 
may then gradually diminish, until it becomes entirely 
extinct. Were this the case, however, the disease itself 
should also increase and diminish in malignancy ; yet 
such was nowhere the fact. In every town where 

* The unusual prevalence of intestinal affections which chanced in some 
places to precede the incursion of cholera, is claimed by the non-contagionists 
as a fact in support of this hypothesis ! To be of any value, however, such a 
fact as this ought to be, if not universal, at least general in its occurrence. 
But so far from this being the case, there is not a town out of twenty of those 
which cholera has visited, in which any such precursor has been witnessed. 
Even in several of those places where cholera was preceded by intestinal affec- 
tions, there is sufficient evidence to show that there was no relation between 
the diseases. In Philadelphia, for example, the intestinal affections which had 
been prevailing there for some time, had so completely died away, two weeks 
before the incursion of cholera, that " out of one thousand patients in the 
alms-house, there were not four who labored under intestinal affections of any 
kind." Indeed, the deluded citizens were congratulating themselves on the 
" mild form in which the pestilence had passed over them," but three days 
before its arrival ! In Baltimore, too, those affections, instead of becoming 
more and more aggravated as the cholera approached, had almost entirely 
subsided when it arrived. 

But there is one fact which sets this whole matter at rest. It is, that the 
" Cholerine," as it was termed, prevailed in the country just as much as it did 
in town — while it is a notorious fact that cholera did not prevail at all as an 
epidemic in the country. This needs no comment. 

The ordinary intestinal affections which prevail during the summer months, 
to a greater or less extent in almost every climate, sometimes become so aggra- 
vated by thermometrical and other atmospherical changes, as to assume an 
unusual degree of prevalence. Such was the case in several parts of this con- 
tinent in the summer of 1819, as well as in that of 1832; and such is the 
case occasionally in every country. Would it be surprising then if cholera, in 
making so extensive a tour, had chanced to visit many places while suffering 
under an aggravation of those affections ? It would certainly be surprising if 
it had not. It is preposterous then to assert, because cholera did visit some 
places under these circumstances, that it must have had a necessary connec- 
tion with the prevailing disease. Others were just as reasonable, who inferred 
that cholera was necessarily connected with the unusual rains, the unusual 
heats, the unusual rays of light, the unusual quantity of insects, and a great 
many other unusual things which chanced to prevail in some places when the 
disease made its incursion. 



EVIDENCES OF CONTAGION. 53 

cholera has appeared, the first cases and the last were 
just as malignant as those which occurred at any other 
period; so that the terms " increase and decline" have 
nowhere had application to its malignancy, but simply 
to the number of its victims. But even were this 
hypothesis true, still it would not explain to us why 
this vitiation, after it had reached its highest point of 
malignancy, should be so gradual, and so partial in its 
manifestations ; since it must necessarily have prevailed 
in all parts of the city at the same time. But again, 
this time is generally much longer in large towns than 
small ones, and longer in small towns than in camps, 
jails, alms-houses, and other crowded assemblages of 
men. Now, let me ask what reason can be assigned 
for those differences in time, if the disease depend on a 
vitiation of the whole atmosphere of a city? Would 
not the poison be brought in contact with all the citizens 
of Calcutta, where the disease continued six months, just 
as soon as it would with all those of Fredericktown, 
where it remained but five weeks ? Would not all who 
were susceptible be simultaneously exposed, and simul- 
taneously cut off, whether they were scattered over ten 
square miles, or confined within the precints of an alms- 
house ? Why then should this disease continue longer 
in a large city than in a small town, or longer in a small 
town than in an alms-house ? Besides, cholera is just as 
malignant at first, as it is at any other period:* and all 

* It is supposed by some, indeed, that the first cases are the most malig- 
nant. But any differences of this kind are merely accidental, and may be 
accounted for by referring to the different susceptibilities of the victims. See 
Orton, p. 449. 



54 EVIDENCES OF CONTAGION. 

i 

the susceptible are at once exposed to its influence: why 
then has it any period of increase — and why is not its 
first onset the most mortal part of its career ? It is un- 
necessary to pursue this point further ; for it must ap- 
pear evident that cholera cannot depend on any gradual 
vitiation of the atmosphere, since there is no gradual in- 
crease in its malignancy ; and it is equally certain that 
it does not depend on any general vitiation, since it is 
gradual, and partial in its diffusion. 

What then does cholera depend on ? May its move- 
ments in a city be reconciled with the idea of local 
origin ?* 

If it depend on local origin, it must either be gene- 
rated at a single point, and from that point diffused 
through the atmosphere to every other part of the city, 
or else it must be generated at many points. If at a 
single point, it will be necessary to assume, that by some 
fortuitous concurrence of circumstances, a poison pre- 
cisely similar to that which was produced at Jessore in 
1817, was again produced in Baltimore in 1832. This 
will certainly be assuming something very wonderful ; 
for it would be strange, indeed, that a concurrence of 
causes, so rare as never to have happened throughout all 
ages, and all countries, till 1817,t should have again 

* Having already treated on the doctrines of " atmospheric influence" and 
"local origin," it may appear superfluous to offer any further refutation of 
them. It must be observed, however, that my remarks in this place, are en- 
tirely restricted to the operations of cholera within a certain sphere : and that 
there are many persons familiar with its movements within this sphere, who 
are but little acquainted with its general history. 

t I am aware that some contend for the earlier origin of this disease, but we 
have the most conclusive facts to show that they have mistaken the local 
cholera, and other diseases, for the pestilence in question. 



EVIDENCES OF CONTAGION. 55 

happened in the year 1832 ; and especially in places so 
different as Baltimore and Jessore. But admitting that 
an event so marvellous did occur, in a certain part of 
Baltimore, (say Buxton lane,) still we shall find it no 
easy task to account for the subsequent diffusion of this 
poison over the rest of the city. In attempting this, we 
must first suppose that the quantity generated in Buxton 
lane was sufficient to contaminate all Baltimore ; for its 
effects were manifested in the most distant suburbs. 
We must next suppose that its diffusion through the 
atmosphere had no power to diminish its intensity ; for 
it was just as malignant in one place as it was in an- 
other: and even after assuming these data, we shall still 
be at a loss to account for the manner of its diffusion. 
It is impossible to conceive how a poison, diffusing itself 
from a single point, should overstep whole streets, so as 
to appear simultaneously at points more remote from its 
origin. It is likewise impossible to conceive how this 
poison, after it had become extinct at its source, should 
still prevail with unabated malignancy in other parts of 
the city. Yet such was undoubtedly the case with 
cholera. For, more than two weeks after this disease 
had entirely ceased in Buxton lane, it swept off whole 
families in the eastern and western sections of the city. 

Shall we, then, in order to obviate all these difficulties, 
presume that this poison originates at many points ? By 
doing this, we may, it is true, obviate some of the diffi- 
culties, but then we shall, at the same time, increase 
very much the number of miraculous coincidences. For 
if, as already stated, it be so very strange that that for- 



56 EVIDENCES OF CONTAGION. 

tuitous concurrence of circumstances which never hap- 
pened before the year 1817, should have again happened 
in Ruxton lane in 1832, what must we think when we 
find similar events occurring, not only in Ruxton lane, 
but in every lane, in every street, nay, in almost every 
house throughout the widely extended city ! And all 
this, too, under circumstances the most dissimilar, so far 
as we are able to appreciate them. In North Charles 
street, in Lexington street, in Fayette street, in short in 
all the cleanest and most respectable streets in Balti- 
more, precisely the same causes must have concurred — 
(for the same effects were produced) as in Ruxton lane, 
in French alley, and in other places remarkable for their 
filth. Whoever could believe in such a chain of wonder- 
ful coincidences, as this view of the subject presents, and 
at the same time disbelieve in any other miraculous 
event — would certainly deserve to lose his character for 
consistency. 

It must appear evident from the foregoing facts, and 
observations, that neither the hypothesis of a general 
atmospheric vitiation, nor that of local origin, can be 
reconciled with the particular movements of cholera after 
it has entered a city, any more than with its general 
progress when traversing a continent: and it now only 
remains to be seen how far these movements may be 
reconciled with the doctrine of contagion. 

The different attributes with which the poison of each 
contagious disease is endowed, must lead us to expect 
corresponding differences in the mode of its progress. 
If a poison be extremely volatile, it will spread, of 



EVIDENCES OF CONTAGION. 57 

course, with greater rapidity than one which is less so ; 
if its power of communicability be strong, it will affect 
a greater number of persons than one whose communi- 
cability is weak : in short, we must expect to find as 
many varieties in the manner in which contagious dis- 
eases are communicated, as there may be supposed 
specific differences in their respective poisons. The 
attributes of cholera poison, which induction justifies us 
in recognizing, have been already stated ; and by keep- 
ing them steadily in view, it will be found that there 
are but few of its progressive phenomena that may not 
be satisfactorily explained. But even should there ap- 
pear many facts, in the progress of this disease, which 
the contagionist could not account for, this would be 
but a feeble argument against the truth of his doctrine. 
We should, on the same ground, reject the contagious- 
ness of measles, scarlatina, and other diseases, many of 
whose phenomena are quite as inexplicable as any of 
those of cholera. Indeed, if we permit ourselves to 
reason in this manner, we must reject the truth of every 
science — since there is not one which is understood in 
all its details. 

Cholera, after it enters a city, first makes its appear- 
ance in a single house:* and this is precisely what we 

* We have some vague reports that cholera has broken out at once over a 
whole city, but they have no foundation in truth. It sometimes happens that 
the disease has been secretly spreading about a city, for eight or ten days, 
before the board of health thinks it prudent to publish it ; and this affords us 
one reason for such reports. But besides this, it frequently happens, that the 
common intestinal affections of the country are mistaken for the foreign cholera ; 
especially by those who find it to favor some particular theory. I know some 
physicians of great eminence who fancied they saw cases of the disease in Bal- 
timore, at least six months before it arrived at Quebec. 



58 EVIDENCES OF CONTAGION. 

should expect of any contagious disease. Were it to 
show itself in a great many houses simultaneously, it 
would be a strong fact against its contagiousness: for it 
would, in that event, be much more rational to attribute 
it to the operation of some general cause, than to sup- 
j)ose that it had been introduced accidentally into so 
many places at one and the same time. It is also in 
accordance with our views of contagion, that the neigh- 
boring houses should be the next to suffer from the 
ravages of the disease. For, besides the free intercourse 
which generally subsists between neighbors, and which 
consequently renders them more liable to contagion than 
those who reside at a distance, the fact may be suffi- 
ciently accounted for by the great volatility of the poison. 
Whoever has experienced the effluvium proceeding from 
the goats that frequent our streets — and which may 
sometimes be smelt at the distance of at least one hun- 
dred yards, can have but little difficulty in conceiving 
how a subtile poison, emanating copiously from one or 
more human bodies, may contaminate the atmosphere 
of a neighborhood. If the different effluvia, proceeding 
from the hare, the fox, the ferret, and the goat, were 
capable of producing specific diseases, each one would 
be communicated at a different distance: — those pro- 
ceeding from the hare, the ferret, and the fox, would 
only be contracted by close approximation ; while that 
from the goat would be communicated across a street, if 
not at a much greater distance. 

That the disease should, after the first six or eight 
days, begin to show itself simultaneously at several 



EVIDENCES OF CONTAGION. 59 

different, and sometimes distant points of the city, with- 
out evidencing the least regard either to topography or 
cleanliness, is another very striking feature in favor of 
its contagiousness. It must ncessarily happen, that in 
the space of six or eight days from the incursion of 
cholera, many persons, residing in different parts of the 
city, will have been exposed to the influence of its 
poison. This will result not only from the number 
whom friendship, duty, or curiosity* may have led to 
visit the abodes of the sick, but also from those who may 
have breathed the atmosphere of an infected district. 
In several of the persons thus exposed, the disease will, 
of course, be developed, and the residence of each will 
form a new point, or focus, from which the poison will 
be radiated. After these points have become very 
numerous, and a great many deaths have occurred, 
there will be scarcely a neighborhood in the whole city 
whose atmosphere will not be more or less contaminated, 
and whose inhabitants will not be, in some degree, 
charged with the poison. f 

This is the mode by which the disease reaches its 
acme ; but the extent of its ravages will depend on cir- 
cumstances which demand particular consideration. It 
will depend, first, on the general susceptibility of the in- 
habitants : secondly, on the number exposed to the poi- 
son : and, thirdly, on the prevalence of exciting causes. 



* Hundreds of non-contagionists visited Ruxton lane for the sole purpose of 
f seeing the cholera!" 

f This will account for that mal-aise which is experienced, in a greater or 
less degree, by almost every individual during the prevalence of cholera. 



60 EVIDENCES OF CONTAGION. 

1. It has been already observed that this poison is, in 
a large majority of cases, incapable of developing disease 
unless assisted by an exciting cause. Those instances in 
which it appears of itself to produce disease, very gene- 
rally occur in persons of weakly and unsound constitu- 
tion ; or in those who have been much exposed at the 
bedsides of the sick, where we may presume the poison 
is most copious and concentrated. It is true, we some- 
times meet with persons of sound and vigorous consti- 
tutions in whom this disease is suddenly developed, 
without any apparent exciting cause, or even premoni- 
tory symptom ; such cases, however, are exceedingly 
rare, and when they do occur, it is generally in the 
wards of a hospital, where it is more than probable that 
excessive fatigue, mental depression, or some inappre- 
ciable irregularity of the corporeal functions may have 
assisted in producing them. Certain it is, however, that 
in a large proportion of those attacked by cholera, the 
disease may be traced to an exciting cause ; and had such 
cause been avoided, we have every reason to infer that 
the disease might have been avoided also. 

It appears, then, that the system of each individual 
possesses, in a greater or less degree, the power to resist 
this poison ; and it is a deficiency of this resisting power 
to which we apply the term susceptibility. When the 
susceptibility is very great, or, in other words, when the 
resisting power is very weak, the poison will, of itself, 
be able to develop the disease. But if, on the other 
hand, the resisting power be great, the system will be 
able to repel (perhaps eliminate) the poison : and it is 



EVIDENCES OF CONTAGION. 61 

only by the cooperation of an exciting cause that it can 
at all disturb the balance of the system, so as to produce 
disease. 

A general susceptibility may result from the long 
duration of excessive heat; from exposure to marsh- 
miasmatic poisons, or impure air of any kind ; from a 
want of nutritious food ; or, in short, from any general 
cause which tends to debilitate the system. In India, 
we are informed that the natives are much more suscep- 
tible of this disease than the European residents ; and 
that those Europeans who have been for some years in 
the country, are more susceptible than those who have 
recently arrived. These differences seem clearly attri- 
butable to the enervating influence of that climate, 
which, by debilitating the system, proportionally in- 
creases its susceptibility to disease. 

In Great Britain, in Germany, and indeed in every 
country whose climate is temperate, and whose inhabit- 
ants are healthy and robust, the ravages of cholera have 
been comparatively limited. The deaths in London, in 
Hamburg, and in Moscow, were by no means so nume- 
rous, in proportion to population, as in Calcutta, New 
Orleans, Havana, and other cities situated in southern 
latitudes, and miasmatic districts. There can, indeed, 
be but little doubt, all things being equal, that warm 
climates are most favorable to the ravages of this dis- 
ease ; for although it has sometimes been dreadfully 
severe, even in the snows of Russia, its severity may 
be satisfactorily accounted for by the habits of the 



62 EVIDENCES OF CONTAGION. 

people, the number and character of exciting causes, 

2. The next circumstance which may influence the 
ravages of cholera is, the number of persons exposed to 
its poison ; and this will depend almost entirely on 
municipal regulations. If the sick, instead of being im- 
mediately removed to insulated hospitals, be permitted 
to remain scattered over the city in their own dwellings, 
the number exposed will be very great ; for the residence 
of each patient will form a spreading point for the dis- 
ease ; and as those points multiply, the poison will 
become more and more diffused, till at length there will 
be scarcely a neighborhood in the city entirely free from 
its influence. It will not be necessary, at this crisis, to 
enter into the dwellings of the sick in order to imbibe 
the poison ; for the atmosphere of almost every street 
and alley will be more or less imbued with it. But it is 
certain, nevertheless, that the danger will be much 
greater at the bedsides of the sick than elsewhere, in 
consequence of the greater concentration of the poison ; 
and it is very obvious, that an unrestricted exposure of 
this kind must add considerably to the ravages of the 
disease. In Baltimore, there were thousands who visited 



* The following extract from Hordynski's History of the Polish Revolution, 
sufficiently accounts for the great mortality in the Russian army : 

" This terrible disease caused us, on the first few days, the loss of nearly 
1000 men ; but if it was terrible with us, nothing can express the suffering it 
produced in the Russian camp, aided by the want of comfort in the arrange- 
ments of that camp, and the acid food upon which the Russian soldiers were 
habitually fed." 



EVIDENCES OF CONTAGION. 63 

the most infected districts, and exposed themselves, 
unnecessarily, in a variety of ways ; and all because they 
had been told that the disease was not contagious ! 

3. The prevalence of exciting causes, must also ex- 
ercise a most important bearing on the ravages of 
cholera. For, no matter how great may be the general 
susceptibility, or how extensive the exposure to the 
poison, still the number of victims will be comparatively 
small, if there be no causes to assist in developing the 
disease. We are justified in this assertion by the fact, 
that in a large majority of those attacked with cholera, 
its development can be traced to the supervention of an 
exciting cause ; while they who carefully avoid such 
causes, almost invariably escape the disease, although 
exposed to its poison. 

It is, indeed, probable that in many instances, where 
the disease has been traced to an exciting cause, such 
cause was not at all necessary to its development ; the 
poison itself being sufficiently powerful for that purpose : 
and on the other hand, it is not unlikely that many of 
those cases, which we presume to have resulted from the 
unassisted operation of the poison, owed their develop- 
ment to some mental or corporeal irregularity, which it 
was impossible to trace. However this may be, one 
thing is certain, that the disease is, in a large majority 
of cases, preceded by some one or other of those circum- 
stances which we recognize as exciting causes. 

The exciting causes are very numerous, and may be 
viewed as general and particular. 

The general causes are all those which, under ordi- 



64 EVIDENCES OF CONTAGION. 

nary circumstances, tend to disturb the balance of the 
system ; and thereby subject it to the influence of what- 
ever is injurious. Such, for example, as sudden changes 
in the condition of the atmosphere, whether thermo- 
metrical, hygrometical, barometrical or electrical ; inor- 
dinate exercise of the passions ; fatigue either of mind 
or body ; loss of sleep ; indigestible food, &c. 

The particular, or as they might be termed, specific 
exciting causes are such as, under ordinary circumstances, 
are found to produce no inconvenience whatever ; but 
when taken into a system impregnated with the poison 
of cholera, become the most deadly exciters of the dis- 
ease. Indeed, many of them consist of articles of diet 
universally admitted to be wholesome and nutritious ; 
and why they, in particular, should exercise so baneful 
an influence, it is impossible to conceive. The fact, 
however, is indisputable, that while beef, mutton, and 
other strong articles of diet, can be eaten with impunity, 
peaches, apples, melons, and other delicate and delicious 
fruits* act as the most deadly poisons ! I have myself 
known several instances in which a single mouthful of 

# Some persons contend that " ripe fruit, provided it be good and fresh," 
will not excite the disease. It is evident, however, that they permit them- 
selves to be governed by theory rather than by facts. Nearly one-third of the 
cases of cholera among the negroes of Baltimore, were traced to the moderate 
use of watermelons alone : and I presume no one will contend that those 
melons were less ripe, or less fresh, in 1832, when they proved so fatal — than 
in former years, when they caused no inconvenience. Several arrive at the 
conclusion, that ripe fruit must be harmless, because they have seen a few 
persons indulge in its use with impunity. It should be remembered, however, 
that all persons are not necessarily exposed to the poison, and that among 
those who really are, there may be some in whom even unripe fruit could not 
excite the disease. It is not by marking the exceptions that we can disprove 
the rule. 



EVIDENCES OF CONTAGION. 65 

fruit has been immediately followed by an attack of 
cholera ; and the examples are innumerable, in which a 
moderate quantity of peaches, apples, pears or melons 
has led to the development of the disease. It would be 
tedious to enumerate the many particular causes that 
have been recognized as exciters of cholera ; for there is 
scarcely any crude vegetable, and perhaps no fruit what- 
ever, that does not act with more or less power in this 
respect. The force of an exciting cause must be greatly 
modified by the susceptibility of the individual, as well 
as by the quantity of poison imbibed ; and this renders 
it exceedingly difficult to determine, with accuracy, what 
causes really are the most powerful. If the suscepti- 
bility be great, and the system at the same time highly 
charged with the poison, the slightest cause may destroy 
the balance of health : while on the other hand, if the 
susceptibility be slight, and the quantity of poison small, 
even the most powerful exciting causes may not be able 
to develop the disease. It is certain, at all events, that 
crude vegetables and fruits are among the most powerful 
of the particular exciting causes ; and this, no doubt, is 
one reason why the disease is so destructive during the 
warm seasons ; for then it is that fruits and vegetables 
are most abundant.* 

The general susceptibility of the inhabitants — the 
number exposed to the poison — and the prevalence of 



* Is it not probable that the great mortality in Paris, Quebec, Montreal, 
New Orleans, and other cities of French habits, was, in a great measure, occa- 
sioned by the diet of the inhabitants, which consisted principally of fruits and 
vegetables ? 
E 



66 EVIDENCES OF CONTAGION. 

exciting causes — are three circumstances then, on each 
one of which the ravages of cholera must greatly depend. 
If the general susceptibility be slight, the exposure to 
the poison limited, and the exciting causes few, the 
power of the pestilence will be almost entirely paralyzed; 
and it will only appear as a sporadic disease. Should it, 
under such circumstances, enter a house, even in the 
centre of a large city, it will be scarcely possible for it 
to become generally diffused. For if we extend the 
number of attendants, or persons necessarily exposed 
even to ten, it is more than probable, should they be 
but little susceptible, and at the same time careful to 
avoid all exciting causes, that not one out of the number 
will suffer from the disease : and even should two-thirds of 
them manifest the premonitory symptoms, such symp- 
toms may, in four out of five cases, be dissipated by a sin- 
gle prescription. Admitting, however, that one-half the 
number exposed should, by their own negligence, suffer 
themselves to become victims to the disease, still it is 
not necessary that they should also become the means of 
spreading its poison. Were these five persons, thus 
attacked, promptly removed to an insulated* hospital, 
instead of being permitted, as is generally the case, to 
form spreading points for the disease — the poison would 
be at once arrested in its diffusion, and owing to its 
great volatility, would soon become extinct. Such was 

* Such a hospital (a single hospital would, under such circumstances, be 
sufficient for a whole city) might be provided as the proudest citizens would 
be glad to resort to ; and that, too, for less money than was expended in 
sweeping the dust out of the streets — under the impression that the disease was 
of local origin. 



EVIDENCES OF CONTAGION. 67 

the result in Boston, in Brussels, and in other cities 
where these precautions were taken ; while in New 
Orleans, Havana, Tampico, and other places in which 
we may presume the general susceptibility was strong, 
the exposure great, and the exciting causes prevalent, 
the ravages of the disease were frightful. Indeed, by 
considering attentively those three circumstances of sus- 
ceptibility, exposure,* and exciting causes, we shall be 
able, in almost every instance, to account satisfactorily, 
for the extent to which cholera may prevail. 

After the disease has reached its acme, it begins to 
decline, pretty generally in the same ratio in which it 
had increased, till at length it becomes entirely extinct. 
This is the case with all contagious diseases : — after the 
poison of small- pox, measles, or scarlatina has been 
brought into contact with a majority of the susceptible, it 
begins generally to subside as its subjects diminish, till 
at length it expires for want of new victims. The time 
which a disease will require for its increase or decline, 
must depend very much on the volatility of its poison. 
If the poison be but little volatile, it will require a long 
time to be brought into contact with a majority of the 
susceptible ; and its increase and decline will be propor- 
tionally slow. If, indeed, it be of so fixed a nature as 
to be easily retained in fomites, it will sometimes lurk 
about, even for years, before, it becomes entirely extinct. 
Of this character is the poison of small-pox. 

* It is quite probable that the poison of cholera, like that of small-pox, and 
other contagious diseases, is favored in its diffusion, by particular conditions 
of the atmosphere, and this may influence very considerably the degree of 
exposure. 



68 EVIDENCES OF CONTAGION. 

The poison of cholera, being extremely volatile, runs 
its course with proportional rapidity. In a city of one 
hundred thousand inhabitants, it generally requires but 
five weeks to reach a majority of the susceptible ; and 
five weeks more suffice for its decline. In smaller 
towns, as might reasonably be expected, its course is 
still shorter; and in condensed crowds, where the ex- 
posure is almost simultaneous, it is frightfully rapid in 
its career. 



PARTICULAR FACTS. 

Having now, I trust, satisfactorily shown, on general 
principles, that the doctrine of contagion is the only one 
with which the progressive phenomena of cholera can 
be reconciled, I next proceed to the consideration of 
such particular facts as will confirm the truth of my 
proposition. In doing this, it will be unnecessary to cite 
any of those numerous facts, which the writers of Asia 
and Europe have recorded, in favor of the contagious- 
ness of cholera ; as it would be impossible, in a brief 
treatise like the present, to notice one out of every hun- 
dred which the disease presents, even since its arrival on 
our own continent. There are, indeed, but few towns 
or villages, within the whole range which this pestilence 
has taken, between Quebec and New Orleans, which do 
not record some unequivocal facts in favor of this doc- 



EVIDENCES OF CONTAGION. 69 

trine ; and if we permitted ourselves to notice such facts 
as, although somewhat equivocal in their character, 
afford, nevertheless, strong evidence of contagion, a folio 
volume would not contain them. 

But it is not with foreign, nor equivocal, nor contra- 
dictory facts, that I shall, in this place, have any thing 
to do ; for I am well aware that the chief obstacle to the 
settlement of this question, may be found in the many 
collateral and irrelevant discussions to which such facts 
have given rise. My object is, simply to state a few of 
those decisive facts which have occurred within our own 
country, and from which there can be no rational appeal. 
Facts, than which none can be stronger, (short of inocu- 
lation,) to prove the contagiousness of any disease. 

1st. Introduction of cholera into Quebec. — The brig 
Carricks, James Hudson master, sailed from Dublin 
some time in April, 1832, with 175 emigrants on board, 
bound for Quebec. The cholera, which was prevailing 
in Dublin at the time of her sailing, broke out among 
her passengers a few days after she left port ; and before 
the 3d of June, the day on which she arrived in Quebec, 
forty-two of them (nearly one-fourth of their whole 
number) had died of the disease ! Notwithstanding this, 
the remaining passengers, amounting to 133, were per- 
mitted to land on Grosse isle, a few miles from Quebec, 
and no rigid measures were adopted to prevent inter- 
course between them and the inhabitants of the city. 
On the 6th, 7th, and 8th of June, several cases of 
cholera appeared in Quebec, and on the 9th, fifteen cases 
were officially reported. 



70 EVIDENCES OF CONTAGION. 

This was the commencement of cholera in the Western 
Hemisphere ; and Quebec was the starting point from 
which it proceeded, step by step, to the innumerable 
places which it has since visited. 

This statement, the authenticity of which may be 
proved by the reports of the board of health of Quebec, 
and by the journals of that city, affords conclusive evi- 
dence that the cholera was imported by the brig Car- 
ricks. The non-contagionists, however, have endeavored 
to invalidate this fact by urging two objections : one is, 
that no person had died on board the Carricks, for some 
weeks before she reached Quebec ; the other, that cholera 
had been prevailing in Quebec, for some weeks before 
her arrival. The first of these objections, even admit- 
ting it to be true, is of but little weight : that forty-two 
persons died, some time during the passage, is not 
denied ; and if cholera may be conveyed at all in fomites, 
(and there are numerous facts to show that it may,) the 
opportunity never was better than in a confined vessel, 
on board which such dreadful mortality had prevailed. 

That the other objection has no foundation in truth, 
will be made appear by the following extracts of letters 
from the house of Messrs. H. Gates & Co. of Montreal : 

" Montreal, Jane 9. 

" We regret to say that one vessel from Dublin, with 
a full number of emigrants, has lost forty- two persons 
during her voyage, by an unknown disease, as is re- 
ported : although the remainder of the passengers and 
crew are said to be now perfectly healthy. The vessel 



EVIDENCES OF CONTAGION. 71 

lies at the quarantine ground below Quebec. An inves- 
tigation is going on by the physicians to ascertain and 
report the character of the disease. Some little alarm 
was excited, by the supposition that it was the cholera, but 
the public mind is more at ease within a day or two." 

" Montreal, June 11. 

a We refer to ours of the 9th inst. and regret to say 
that the unknown disease alluded to, as having swept off 
forty-two of the emigrant passengers on board the Car- 
ricks from Dublin, proves to be the cholera, and the dis- 
ease is now officially ascertained as existing in Quebec, 
where fifteen cases were reported on the 9th inst. and 
several deaths." 

If we take any other view than that of contagion, it 
will be impossible even to imagine why cholera should 
have visited Quebec first. If it crossed the Atlantic in 
the atmosphere, it must have passed over Nova Scotia 
and New Brunswick before it reached Quebec ; and yet 
we find it did not visit the former places till after it had 
ravaged the latter ! If it crossed in the atmosphere, it 
proceeded in a single line, and that line so narrow as to 
have touched only Quebec; yet we find that after it 
touched that city, it proceeded in thousands of lines ! 
Unless, then, we admit that the disease was imported in 
the Carricks, it will be impossible to give a reason for 
its travelling over the Atlantic in a single line, and over 
the continent in thousands of lines. Besides, if it crossed 
in the atmosphere, there were many hundred chances 



72 EVIDENCES OF CONTAGION. 

for its arriving either before or after the brig Car ricks ; 
yet we find that they both arrived at the same time ! 

If the cholera did not cross in the brig Carricks, nor 
in the atmosphere, it must have originated in Quebec ; 
and if it did originate in Quebec, it must have preferred 
that city to any other in the western world, without our 
being able to assign the slightest cause for such prefer- 
ence ! Besides this, it is a strange coincidence, that 
cholera should have chanced to originate in a city, to 
which emigration was greater than to any other — and 
that, too, at the critical moment when an infected vessel 
arrived there ! 

It is also to be observed, that if cholera originated in 
Quebec, there was no reason why it should next have 
originated in Montreal, any more than in New Orleans ; 
or in Albany, any more than in Tampico ; yet it 
originated in an unbroken chain, of which Quebec 
formed the first link ! 

No vessel, with cholera on board, had ever arrived in 
Quebec till the 3d of June, 1832 ; and no case of cholera 
had ever appeared there till the 6th of the same month ; 
what, then, could be more astonishing than that two 
events, neither of which had happened throughout all 
ages before, should both have chanced to occur at the 
same time, and yet have had no necessary dependence 
on each other ! 

The contagionist removes every difficulty, by stating 
as follows : the brig Carricks, crowded with emigrants, 
on leaving the infected port of Dublin, carried with her 
the seeds of cholera ; these seeds in due time developed 



EVIDENCES OF CONTAGION. 73 

the disease, and this disease, owing to the concentration 
of its poison, swept off the frightful proportion of one- 
fourth of the number exposed. The surviving passen- 
gers of this vessel, many of them perhaps laboring 
under the milder forms of cholera, were permitted, on 
arriving at Quebec, to have intercourse with the in- 
habitants ; and the disease was in this manner commu- 
nicated, first to that city, then to Montreal, and so on to 
every place where such intercourse extended. Such is 
a rational explanation of the facts on this subject ; and 
by it we are enabled clearly to understand why the first 
appearance of cholera on the western continent, coin- 
cided so exactly with the first arrival of an infected 
vessel. 

2d. Introduction of cholera into Folly Island. — Some 
time in October, 1832, the brig Amelia, with one hun- 
dred and eight persons on board, sailed from New York, 
where cholera was still prevailing, for New Orleans. 
On the sixth day out, sickness commenced on board, 
some dying in a few hours, and others lingering for 
several days. The physicians on board pronounced the 
disease to be cholera, and twenty deaths occurred at sea. 
On the 30th of the same month, the brig was stranded 
on Folly Island, which is situated about ten miles from 
Charleston ; and in a day or two afterwards, the disease 
began to spread among the inhabitants of that island. 
The persons employed about the wreck were the first 
attacked, and the most severely afflicted ; and it will be 
seen by the following extract, taken from the official 
report of the intendant of Charleston, dated the 7th of 



74 EVIDENCES OF CONTAGION. 

November, that the authorities were so firmly convinced 
that the brig was the source of the disease, that they 
ordered both her and her cargo to be completely con- 
sumed. 

" The wreckers employed about the vessel and cargo 
of the Amelia have suffered much : six out of seven 
deaths which occurred on the 6 th inst. being of their 
number. The intendant, board of health, and the 
attending physician on the island, came to the conclusion 
that the wreck, containing a large quantity of infectious 
matter, has essentially contributed to the propagation of 
the malady ; if, in fact, almost every case that has oc- 
curred be not distinctly owing to that cause. Accord- 
ingly, orders were given by the public authorities to have 
the vessel and cargo burned as completely and effectually 
as possible, which was accordingly done." 

In addition, it may be proper to state, that before the 
arrival of the brig Amelia, no case of cholera had ever 
occurred within two hundred miles of Folly Island. 

3d. Introduction of cholera into Detroit. — The cholera 
was introduced into Detroit by the United States troops, 
on board the steam-boat Henry Clay, as will appear from 
the following extract, taken from the Detroit Journal of 
the 11th of July, 1832 : 

" We are obliged to announce to our readers that the 
spasmodic cholera has made its appearance in this city. 
As might be expected, the prevalence of such a malig- 
nant disease among us has produced very general alarm 
among our citizens. The first case occurred on the 5th 
inst. among the troops on board the Henry Clay. The 



EVIDENCES OF CONTAGION. 75 

subject, who was a soldier of intemperate habits, expired 
after an illness of seven hours. Others were soon after 
taken ill, and all of them exhibited the usual symptoms 
which are said to attend the disease. The vessel was 
ordered to leave the port, and she proceeded to Hog 
Island, where she was furnished with supplies from this 
city for her voyage to Chicago. On Friday the 6th, two 
cases occurred in town. The individuals had been employed 
the day previous to communicate with the boat. One of 
them recovered, the other died the next day. On Satur- 
day and Sunday other cases occurred." 

The Henry Clay had touched at several places where 
cholera was prevailing, before she reached Detroit ; and 
that town, up to the time of her arrival, had enjoyed its 
usual health. 

4th. Introduction of cholera into St. Michaels. — Some 
time in August, 1832, Captain Dodson returned from 
Baltimore, where the cholera was then raging, to St. 
Michaels, a small town on the Eastern Shore of Mary- 
land. While on his passage, he was attacked with this 
disease, and on the morning of his arrival at St. Michaels, 
he died. In a day or two after his death, other cases of 
cholera occurred there ; and it will be seen by the fol- 
lowing extract from the Easton Whig, of September 4th, 
that the disease became general among the inhabitants 
of that village : 

"St. Michaels continues to be sorely afflicted with this 
dreadful disease. Since the death of Captain Dodson, 
from the best information we have been able to pro- 
cure, there have been eighteen or twenty cases of un- 



76 EVIDENCES OF CONTAGION. 

doubted cholera, about one half of which have terminated 
fatally." 

The situation of St. Michaels is known to be in one 
of the most healthy sections of the Eastern Shore ; and 
its inhabitants had never enjoyed better health than im- 
mediately before the arrival of Captain Dodson. The 
whole circumjacent country has remained, to this day, 
untouched by cholera. 

5th. Introduction of cholera into Charles county. — As 
this fact is faithfully and circumstantially related by 
William L. Brent, Esq., in a letter to the editors of the 
National Intelligencer, it will only be necessary to make 
an extract from that gentleman's communication ; and 
this I shall give without comment : 

" In your National Intelligencer of the 18th inst. you 
state that in a square east of Mr. Packard's milk estab- 
lishment, there have been eleven deaths out of a popu- 
lation of sixty. This mortality is nothing to that which 
has taken place on the plantation adjoining mine, belong- 
ing to the widow of the late Dr. Brent, and tenanted by 
Mr. Philip Steuart, the son of our old friend, General 
Steuart. I am told that the number of persons on the 
plantation did not exceed eleven, out of which eight 
have died, including Captain Gibson and Mr. Washing- 
ton, with the cholera ; and I am informed by one of my 
servants this morning, that another is at the point of 
death. I cannot relate facts as of my own observation, 
as I assure you so violent is the disease, and so fatal in 
its attacks, that I have not only been afraid to visit that 
plantation, but have forbidden all communication to or 



EVIDENCES OF CONTAGION. 77 

from it.* The facts as stated to me, (and Dr. Pattison 
and others may reason as they please,) prove the disease 
to have been contagious in this case. A captain of a 
vessel from Georgetown, whose name was Gibson, landed 
at the plantation, to that moment perfectly healthy, and 
died with the cholera, and was buried there. A day or 
two after, a negro man was attacked in the same way, 
and died, and since then four more negroes have died in 
the same way, and with the same disease. The over- 
seer (Mr. Martin) rode up to a friend's house in the 
country, a day or two ago, was taken on the road, and 
died in a few hours after he reached his friend's house : 
and a Mr. Washington, formerly of your city, or George- 
town, who went to the plantation, was taken, and died 
in a few hours. The plantation is thirteen miles from 
Alexandria, upon the Potomac, and is considered as 
healthy as any in the neighborhood." 

6th. Introduction of cholera into a farm-house. — This 
fact is taken from the Delaware Watchman, of August 
24th, 1832. 

" A few days since, a young lady from Philadelphia, 
which place she left on account of the prevailing epi- 
demic, arrived at the house of her father-in-law, who 
resides in the western part of this county, where she 
contemplated staying until the disease should so far 
abate as to warrant the safety of her return. She was 
much rejoiced that she had been so fortunate as to make 
her escape ; but, alas ! her joy was of short duration. 

* lam authentically informed that the disease did not spread beyond this 
plantation. 



78 EVIDENCES OF CONTAGION. 

In the evening of the day on which she arrived, she par- 
took of a small quantity of fruit before retiring to bed, 
which caused almost an immediate attack of the disease ; 
and notwithstanding every exertion was made by her 
friends to relieve her of the excruciating pain under 
which she was suffering, next day she was a corpse. 
Two others of the family were shortly after attacked, 
both of which cases proved fatal." 

" The alarm which had now been created in the 
family was so great, that it became necessary to call on 
the neighbors for assistance, but owing to the excitement 
which the melancholy intelligence occasioned, none could 
be induced to render the assistance required. At length, 
a lady in the neighborhood, after having been assured 
by the physicians in attendance, that there was nothing 
to fear, was prevailed on to aid them in the deplorable 
situation under which they were placed. But having 
suffered her feelings to become so much excited, she was 
compelled to return home, when, sad to relate, she too 
was attacked, and soon after died. A black woman in 
the family in which the first cases occurred, has since 
died with the same disease, and at this time, we regret 
to learn there are six more confined to their beds, among 
which number is the head. This is another evidence of 
the hopelessness of an attempt to flee from the monster 
which is visiting cities, town and hamlets, leaving deso- 
lation and death in its train."* 



* Strange as it may appear, this is the manner in which almost every editor 
in the United States (under the delusion of non-contagion) dissuaded persons 
from leaving the infected towns ! If, out of five hundred refugees, two or 



EVIDENCES OF CONTAGION. 79 

7th. Introduction of cholera on the New Jersey Canal. — 
A New York paper of the 7th of August, 1832, gives the 
following account of the introduction of cholera among 
the laborers on the fortieth section of the New Jersey 

canal : 

"Princeton, (N. J.) August 4. 

" We have learned with regret that the cholera has 
been making great ravages on one section of the canal — 
No. 40, about seven miles from this place, in the valley 
of the Mill Stone. The adjoining sections of the canal 
are perfectly free from the pestilence, and indeed on the 
whole line from Lambertville to Trenton, and from Bor- 
dentown to New Brunswick, with this exception, the 
laborers enjoy good health. On Thursday the 26th ult. 
a pedler from New York arrived on this section at night, 
was seized at five o'clock on Friday morning, and died 
the same afternoon. During this day three, engaged on 
the work, were taken and died on Friday night; on 
Saturday, Sunday and Monday, seven more were seized, 
and six died ; on Tuesday, two more were attacked and 
died on the work ; and Mr. Elmendorff, a highly re- 
spectable and worthy man, whose house is within the 
district, also died — thus making, on this one section, 
fourteen cases and thirteen deaths. On Tuesday the 
hands were all discharged and left the work." 

8th Introduction of cholera among the Indians. — The 
Utica Sentinel of the 7th July, 1832, after stating that 

three chanced, by fleeing too late, and by thus carrying with them the seeds 
of the disease, to die, after they had reached the country, their deaths were 
almost invariably cited as instances of the folly of trying to escape ! 



80 EVIDENCES OF CONTAGION. 

the city had continued perfectly healthy up to that time, 
subjoins the following article : 

" Cholera among the Indians. — A few days since an 
Indian, belonging to Oneida Castle, twenty-three miles 
west of this city, was hired by the captain of a passing 
boat, to bury a man who had died of cholera on board. 
He procured some other Indians to assist him. He was 
immediately seized with the cholera and died — five other 
Indians were taken, all of whom died. No other cases 
have occurred. 

9th. Introduction of cholera into Staten Island. — This 
fact is taken from the New York Evening Post. 

" We regret to learn that cholera has appeared at the 
Seamen's Retreat, on Staten Island, about one mile 
below the quarantine ground. Nearly one hundred in- 
valids have been inmates of the establishment for the 
first year ; and being nearly all more or less subjects for 
the disease, the greatest precautions have been taken by 
Dr. Townsend and the trustees, to prevent its appearance 
at that place ; being obliged, however, to receive seamen 
from the city, as well as from vessels, one or two persons 
have recently been taken in from the city, who soon 
were taken, and died by cholera. Ten other cases have 
appeared, within two days, all of which are con- 
valescent." 

10th. Introduction of cholera into the Marine Settlement, 
Illinois. — It is stated by a St. Louis paper of the 24th 
of May, 1833, that the cholera had made its appearance 
at the Marine Settlement in Illinois, about twenty-four 
miles east of that place. The first case occurred in a 



EVIDENCES OF CONTAGION. 81 

laborer in the employ of Captain Blakeman. This man 
had been on a visit to St. Louis, where cholera was 
then prevailing, and immediately after his return, sick- 
ened and died of the disease. Shortly after, Captain 
Curtis Blakeman, and his daughter, a young lady about 
fifteen years of age, were attacked and died, and Mrs. 
Blakeman survived them but a few hours. 

11th. Introduction of cholera into Key West. — On or 
about the 26th of April, in the present year, the brig 
Ajax sailed from New Orleans, bound to Liberia with 
nearly 150 emigrants on board, and was compelled after 
she had been fifteen days at sea, to put into Key West 
in distress. She lost her mate and two blacks, when she 
had been but two days out, and the ship carpenter 
aboard reported that thirty or forty of the emigrants 
died of cholera, whilst the brig was anchored off the 
town. 

Having remained at Key West for about five days, 
the Ajax left there on the 16 th of May for the place of 
her destination. Immediately after her departure, the 
disease broke out in the town — and between the 16th 
and 27th, fifteen cases and nine deaths occurred, out of 
a population of two hundred. 

When the Ajax left New Orleans, the cholera was pre- 
vailing there, and before her arrival at Key West, a case 
of the disease had never appeared within three hundred 
miles of that island. 

12th. Introduction of cholera at Plymouth Locks. — In 
the early part of August, 1832, when the cholera was 
raging at Philadelphia, a laborer, who had been dis- 



82 EVIDENCES OF CONTAGION. 

charged from Arch street prison, during the dreadful 
mortality that prevailed there, made his appearance at 
Plymouth Locks, in quest of work. Shortly after his 
arrival he was seized with cholera, and in a few hours 
died. Scarcely had he been interred, before others were 
seized — and in a few days, fifteen cases and nine deaths 
had taken place out of about twenty individuals ! The 
neighborhood about the locks had continued as healthy 
as usual till the arrival of this laborer. 

13th. Introduction of cholera into New Haven, — About 
the 8th of July, 1832, when the cholera was prevailing 
in New York, a Mrs. Northorp and her son fled from 
that city to take refuge in New Haven, the residence of 
her parents ; and immediately after their arrival, both 
sickened and died of cholera. Two days after their 
deaths, Mr. and Mrs. Jones, the parents of Mrs. Nor- 
thorp, who had nursed her during her sickness, were 
also seized with the disease, and died on the morning of 
the 4th of July. These were the first cases of cholera 
which occurred in New Haven — and neither Mr. nor 
Mrs. Jones had visited any place where the disease was 
prevailing. 

14th. Introduction of cholera into the Alms-house near 
Flathush. — The Long Island Star relates the following 
fact: 

" There have been several cases of cholera, and some 
deaths at the new alms-house of King's county, situated 
in an isolated spot, a short distance from Flatbush. 
There are now no more remaining. The first occurred 
on the 17th of July, in a man who had been more or 



EVIDENCES OF CONTAGION. 83 

less intoxicated for six weeks at William sburgh, and was 
brought to the alms-house with symptoms of spasmodic 
cholera. He died on the 21st. Since this case, there 
have been six cases of malignant spasmodic cholera, and 
three deaths ; four cases of mild spasmodic cholera, and 
eight cases of common cholera morbus, none of which 
were fatal. There have been no more new cases since 
the 26th of July." 

15th. Introduction of cholera into Nyack. — The town 
of Nyack, situated in the state of New York, had re- 
mained perfectly healthy till towards the last of July, 
1832, when a Mrs. Leydecher arrived there from New 
York, and died of cholera on the same night of her ar- 
rival. Immediately after her death, Mr. Leydecher, her 
father-in-law, took the disease and died. Mr., Mrs. and 
Miss Graham next fell victims in quick succession, and 
the disease after that began to spread generally among 
the inhabitants. 

16th. Introduction of cholera into Fort Armstrong. — 
The following is from the Washington Globe : 

« We regret to learn that the cholera has appeared 
among the troops at Fort Armstrong. The most judi- 
cious measures seem to have been adopted by General 
Scott, and maintained with the greatest vigilance and 
constancy, to prevent the spread of infection. The force 
under his immediate command appears to have been 
preserved free from it until the 25th ult. On the even- 
ing of that day, one of the mounted rangers of Captain 
Ford's command, who was for a short time in Fort Dear- 
born (Chicago) on the 10th, was received into Fort 



84 EVIDENCES OF CONTAGION. 

Armstrong, sick, as afterwards appeared, with the 
cholera. Between the 26th ult. and the 1st hist., there 
were one hundred and forty-five cases ; twenty-six died, 
twenty-two were recovering, and six were perfectly 
cured." 

17th. Communication from Dr. H. G. Doyle, of Wash- 
ington, Mississippi. {From Hagerstown, Maryland.) 

" On Sunday, the 4th of August, 1833, a woman from 
the line of the canal was taken to the hospital of this 
town, and died of cholera. On Monday morning the 
5th, an aged colored woman was found dead in her house 
in the immediate neighborhood of the hospital, having 
died, from the account of her husband, in about two 
hours after her attack, of cholera. On Monday after- 
noon, same day, another old colored woman residing in 
the same house, died in a few hours after her attack. 
On Tuesday morning the 6th, two old black men, Nace 
and Stephen, were attacked ; Nace died on Wednesday, 
and Stephen on Thursday. Nace made his home in the 
house in which the two old women had died, but was 
absent from Sunday night until Tuesday morning. Ste- 
phen lived in the house next to that which had been 
occupied by the old women. In addition to these cases, 
a small girl, on the same lot, was violently attacked with 
spasms on Tuesday morning the 6th, but recovered. A 
few days subsequently, two other deaths occurred in the 
neighborhood of the hospital ; and one in a tavern (at 
which old Nace had stopped on Tuesday morning) seve- 
ral hundred yards from the hospital. Thus far the origin 
of every case may be traced to the hospital. 



EVIDENCES OF CONTAGION. 85 

"About the time of the occurrence of the last mentioned 
cases, a death took place at a tavern on the southern 
border of the town, more than half a mile from the hos- 
pital, a laborer from the canal. Since then three deaths 
have occurred in the same and adjoining house. 

" The disease, with the exception of the case at the first 
named tavern, has been exclusively confined to the 
neighborhood of the two points; the hospital and the 
tavern on the southern border of the town — the balance 
of the town remaining perfectly exempt from it. 

" Hagerstown, Sept. 2d, 1833. 

" Deak Sir : — The preceding history of the late visita- 
tion of cholera asphyxia at this place, was furnished me 
by William D. Bell, Esq., Moderator of the Board of 
Commissioners of Hagerstown. It goes far to establish 
the fact that at least the disease did not put on the livery 
of an epidemic ; and further, that it was communicated 
from one person to another in the same family. 

" The case of Mr. Herman's man, of which I spoke 
when I saw you, was substantially this — Mr. H. pur- 
chased a negro at the city of Natchez, from a trader who 
had just descended the river in a cholera boat ; the day 
after he arrived at his plantation he was taken with 
cramps, accompanied by the peculiar discharges attend- 
ant on cholera patients. I attended the case. Mr. H., 
fearful of the disease spreading amongst his negroes, ad- 
ministered to him himself, and permitted none other to 
visit him. Before the negro had entirely recovered, Mr. 
H. himself was taken, and had a very severe attack of 



86 EVIDENCES OF CONTAGION. 

cholera. He had not been in a cholera atmosphere, nor 
seen any other person laboring under the disease, save 
his own negro. 

" Mrs. H. died at Maysville, about the time of the 
cholera's first appearance at that place. She was taken 
to Flemingsburg for interment, but remained unburied 
until the next day ; and on the same day nine deaths 
occurred amongst those who attended the wake. Fle- 
mingsburg up to that time had been perfectly healthy ; 
from this germ the disease spread and committed the 
most horrible ravages. *My memory does not serve me 
sufficiently to give you an exact detail of the different 
cases, nor can I speak of the Flemingsburg cases from 
personal observation ; but the information was derived 
from a source in which I have the most implicit reliance. 

" Should this brief sketch be of any service to you in 
furtherance of your laudable design, I shall feel much 
gratified, as I believe the establishment of the fact that 
cholera is a contagious disease, will contribute much to 
the preservation of human life, and the prevention of 
human suffering. In great haste, 

Your obedient servant, 

H. Geo. Doyle. 

Dr. B. M. Byrne." 

18th. Extract from the Hagerstown Torch Light of the 
12th of September, 1833, accompanied with a letter from 
William D. Bell, Esq., editor of that journal. 

"Hagerstown, Sept. 12, 1833. 

" On Thursday night last, a person who had been 



EVIDENCES OF CONTAGION. 87 

committed from the neighborhood of Sharpsburg the day 
preceding was attacked with cholera, in the jail of this 
county. He was removed to the hospital without delay, 
and died on Tuesday ; his name was Henry Romley. No 
other case occurred until Saturday last, when two more 
persons were attacked, and removed to the hospital — 
one an old man, name not known, the other named Wil- 
liam Brewer. Brewer died on Saturday night and the 
old man on Sunday morning. John Rogers was attacked 
in prison, on Sunday morning, and died on the same 
day. And a runaway negro, named George Pendleton, 
was attacked on Sunday, and died on Monday, in the 
hospital. Joseph Philips, and an old man named Moy- 
ers, were liberated on Saturday ; Moyers died in Funks- 
town on Sunday, and Philips died in the hospital on 
Wednesday morning. We have not heard of any other 
deaths among those who were in the jail when the dis- 
ease broke out, all of whom, to the number of about 
twenty, have been bailed and liberated. With the ex- 
ception of the cases already noticed, and all traceable to 
the jail, there has been but one other death — that of 
Celia Cook, a colored woman, who resided close to the 
jail. There is, we believe, at present not a single case 
in the town or neighborhood, both of which continue 
unusually healthy for the season. Whole number of 
deaths from Saturday to Wednesday, 8. 

" Hagerstown, Sept. 21, 1833. 
" Dear Sir: — Your favor of the 19th inst. has been 
duly received. In reply to your inquiries respecting the 



88 EVIDENCES OP CONTAGION, 

i 

correctness of the statement (as published in my paper 
of the 12th instant) of the cases of cholera which re- 
cently occurred in the jail, hospital and neighborhood, I 
have to say that it is strictly accurate. The cases in the 
hospital came under my immediate and personal obser- 
vation ; the other cases were reported to me by the at- 
tending physicians. 

" You are at liberty to use my name as authority for 
this statement if you think proper. 

" I believe that no case has occurred in Funkstown, 
since the death of Moyers, and but one in Hagerstown, 
since that of Celia Cooper. This was a colored man, 
named George Coney, next door neighbor of Celia, who 
had helped to place her in the coffin. 

" No case has occurred since the disease broke out in 
the jail, that is not traceable to it. 

" There is one fact which is worthy of remark, per- 
haps, in connection with this subject, that is, that during 
the prevalence of cholera at the hospital, and jail and 
neighborhood, during this entire season, our citizens in 
other parts of the town and neighborhood, were almost 
entirely exempt from diarrhoea and every thing like pre- 
monitories — a fact that goes to show that our atmosphere 
could not have been generally affected. 

Yours, very respectfully, 
• William D. Bell. 

Dr. B. M. Byrne." 



EVIDENCES OF CONTAGION. 89 

19th. Extract of a letter from John Dulin, Esq., Fair- 
fax county, Virginia, dated September 15th, 1833. 

" I saw Mrs. Draper yesterday. She says the man 
whom the doctor attended was named Clark, he resided 
in Colchester,* and traded up the river in a vessel : he 
had just returned from Georgetown in the District of 
Columbia, where he had delivered a cargo of wood, at 
which place the cholera then raged. He was accompa- 
nied by two colored men, one of whom also died about 
the same time. The doctor first saw Clark about 10 
o'clock on Sunday, and continued with him until night, 
he then left him not quite dead ; two men waited on him 
during his sickness, and laid him out after death. 

" The doctor complained somewhat on Monday night; 
all day Tuesday, he said he certainly had the premoni- 
tory symptoms of cholera, but as it was a busy day with 
him, he must put off taking medicine until Wednesday 
morning. He had been out through the day, but re- 
turned home between ten and eleven o'clock. His wife 
asked him to take supper ; he refused : and replied, ' if 
you knew how badly I feel, you would not ask me — I 
am now prepared to take medicine, which I will do in 
the morning.' She was aroused about two o'clock by 
his puking. She asked what was the matter. He said, 
1 1 have the cholera,' and directed something to allay the 
vomiting. A physician was sent for, and his nephew, 
who was with him, desired to bleed him ; he objected, 

* Colchester is eighteen miles distant from the part of the country where 
Doctor Draper lived ; and it is ascertained that the cases of cholera here men- 
tioned, were the only ones that occurred in either neighborhood. 



90 EVIDENCES OF CONTAGION. 

and said it was too late, and died about 10. None of his 
attendants took the disease. A young gentleman in the 
same house with Doctor Draper took the disease five 
days after ; however he did not go into the chamber of 
the doctor. Two servants who waited on him were 
taken some time after him, and died. I think the day 
on which the doctor died, a messenger came for him to 
visit one of the men who was with Clark ; before he got 
back the man was dead, and within a day or two the 
other died. This report of facts is confirmed by several 
others." 

20th. Extract of a letter from a gentleman in Port To- 
bacco, Charles county, Maryland. 

" Dear Sir: — Your letter soliciting information in re- 
lation to the introduction of cholera into Port Tobacco, 
has been received, and I most cheerfully comply with 
your request as far as my knowledge extends. 

" The first case of cholera which occurred in Port To- 
bacco was that of a man by the name of Beall, a resident 
of the county, but not of the town. This man, as I 
have been informed and believe, a few days before he 
was attacked, had been to the Occoquan mills in Vir- 
ginia, in company with his brother, where they went on 
board of a long boat, from the District of Columbia, in 
which a man was ill at the time and died of cholera. 
Beall was taken at night with this disease, at a tavern, 
and died next day. The next case was that of the bar- 
keeper at the tavern where Beall died, and other cases 
followed in quick succession. Beall's brother, who ac- 
companied him to Occoquan, was attacked at home in 



EVIDENCES OF CONTAGION. 91 

the county, and died the same day or the day after his 
brother died in Port Tobacco ; and a third brother, who 
attended the one in the county, died of the same disease 
a few days afterwards. 

" The only family in the neighborhood which was 
visited with this disease, was that of General Matthews ; 
and the first case that occurred was a negro man who 
resided in Port Tobacco, and had a wife and family at 
the general's. This man left Port Tobacco on the even- 
ing of the third or fourth day after the first case occur- 
red in town, was taken that night, and died next day ; 
and four other cases succeeded within a few days there- 
after. The disease was confined entirely to those who 
assisted in nursing, and were in contact with the sick ; 
and what is remarkable, three colored persons who re- 
sided in Port Tobacco, and died of the disease, visited 
one of those who died at General Matthews' during her 
illness — she being an aged female to whom they were 
much attached. This I have heard from good authority, 
and believe it to be true. 

" At the poor-house near Port Tobacco, not a case of 
cholera occurred, until two children were carried there 
with the disease upon them, both of whom died. These 
were the children of a sister of the Be alls before spoken 
of, who, being left friendless, were from necessity taken 
to the poor-house. Whether or not they resided in the 
family with their uncle, who died ' as above mentioned, 
and thereby may have been supposed thus to have con- 
tracted the disease, I am not prepared to say ; but imme- 
diately after their introduction into the poor-house, 



92 EVIDENCES OF CONTAGION. 

several other cases followed ; and I believe about one- 
sixth or seventh of the inmates died. I do not now 
recollect the precise number of deaths, nor is it material 
for your purpose : many, no doubt, were saved by leav- 
ing the town upon the first appearance of the disease ; 
and there was not a single case of cholera with those 
who took this precaution. The town was literally de- 
serted for some weeks, and almost perfect non-intercourse 
established between the town and country. I believe 
there were a few cases in town which could not be traced 
to any immediate contact with a diseased person ; but 
the number was very few, and although they may not 
have come into actual contact, they were almost con- 
tiguous in locality of residence. 

" I have thus, sir, hastily sketched off the information 
required by you, and before doing so, I assisted my own 
recollection of facts by conferring with others. In some 
instances, I found that I had heretofore labored under a 
misconception as to some matters, and probably in what 
I may have stated above, there may be a diversity of 
opinion or of recollections. I have aimed, however, at 
truth, and give you the facts as I understand them. 

" In giving publicity to these facts, I do not wish, 
however, that my name should be introduced, nor do I 
conceive it to be at all necessary. In this place it will 
be known from whom the information is derived, as I 
have spoken of your letter, and of my object in getting 
correct information in relation to the matter in question. 
There are some here entirely opposed to the doctrine of 
contagion ; more especially the physicians. Others, 



EVIDENCES OF CONTAGION. 93 

however, and especially General Matthews, who was an 
eye-witness of the cases in his own family, are decidedly 
of opinion that the disease is contagious. To use a more 
vulgar word, that it is " catching" I have no doubt : — 
whether by actual contact, or by the noxious air arising 
from the diseased person, and thus imparted to those 
who are exposed to its influence, or how it is communi- 
cated, I am not scientific enough to express an opinion. 
I am, sir, respectfully, 

Your obedient servant, 



Dr. B. M. Byrne." 

21st. Introduction of cholera at Govanstown. — The 
last fact which I shall mention, is one that occurred in 
the vicinity of Govanstown, about four miles from Bal- 
timore : 

About a quarter of a mile from Govanstown, lived 
Nicholas Gill and Mrs. Dewees, in two adjoining frame 
houses; and distant from those houses about 100 yards, 
stands a stone house, which was inhabited by Mrs. Gill, 
and her son-in-law, Mr. Cadwallader, together with three 
children. In September, 1832, when the cholera was 
raging in Baltimore, and when Govanstown with its 
neighborhood, for miles around, was perfectly healthy, 
the disease was introduced into two of those houses in 
the following manner : 

Mr. Joshua Gill, a brother of Mr. Nicholas Gill, after 
having spent some three or four days in the city, was on 
his way back to his residence, further up in the country ; 



94 EVIDENCES OF CONTAGION. 

when he was taken suddenly ill on the road, and being 
near the house of Mr. N. Gill, was induced, by the 
severity of his symptoms, to enter and remain. This 
was on Tuesday evening, and on Friday he died of 
cholera. 

Mrs. Gill, of the stone house, waited on Joshua during 
his illness ; and not having any person to take charge of 
the children during her absence from home, she brought 
them into the room where she was nursing. — On the 
ensuing Sunday, herself and the three children were 
seized with cholera, and before midnight they were, all 
four, numbered with the dead. A black woman, an 
inmate of the family, who nursed the sick, was likewise 
attacked on Sunday, and died the next day. Finally, 
the death of Mr. N. Gill, on Tuesday, after one day's 
illness, completed the tragedy. 

Of all those who died, not one, except Mr. Joshua Gill, 
had visited any place where cholera was prevailing. 

Mr. Dewees and Mr. Dobbin had assisted in laying out 
the dead, and were both taken with the premonitory 
symptoms, but recovered. 

Mrs. Dewees, living next door, prevented her children, 
five in number, from having any intercourse with the 
sick ; and she herself visited the infected dwelling but 
once ; neither she nor any of her children was attacked. 

The houses in which those persons died were surpassed 
by none in the vicinity in cleanliness ; — and the habits 
of the inmates, as far as could be ascertained, differed in 
nothing material from those of their neighbors. 

But one other case of cholera occurred, either in 



EVIDENCES OF CONTAGION. 95 

Govanstown or its neighborhood, during the whole sea- 
son ; and that was in the person of a black man, who 
had frequently visited the city during the prevalence of 
the disease. 

The facts here stated may be relied on for their accu- 
racy : they where recorded in the neighborhood where 
they occurred, in my own presence, by a medical gentle- 
man who is a non-contagionist ; — and they are given on 
the concurrent testimony of Mr. and Mrs. Dewees, and 
Mr. Cadwallader, who were themselves witnesses of this 
tragic scene. 

I might cite numerous other facts of this description, 
but I consider it unnecessary : the mind that cannot be 
convinced by so many unequivocal proofs of contagion as 
are here presented, will not be convinced by any amount 
of similar evidence. 

If such facts as these do not prove that cholera is 
contagious, it is impossible to prove the contagiousness 
of any disease, except by inoculation. — It would be no 
easy task to adduce such conclusive facts to prove the 
contagiousness either of measles, hooping-cough, or 
mumps ; yet few will deny that any one of these dis- 
eases is contagious. In truth, there is no disease, not 
imparted by inoculation, which presents so many facts, 
both general and particular, in favor of its contagious- 
ness, as cholera ; — and the wonder is, that men who 
deny the contagiousness of this disease, should be so 
inconsistent as to admit that of measles, hooping-cough, 
scarlatina or mumps. 

I again assert, that no facts can be stronger to prove 



96 EVIDENCES OF CONTAGION. 

the contagiousness of a disease, than such as are here 
stated. If we take, for example, the case of Folly Isl- 
and, it is impossible to conceive how any rational mind 
will resist the conclusion that cholera was introduced 
there by contagion. Folly Island forms but a mere 
speck on the map of the Southern states ; and the 
chances against the cholera appearing there first, must, 
on any other principle than contagion, have been at least 
ten thousand to one ; — and yet that speck was the first, 
and the only place, for hundreds of miles round, where 
cholera appeared ! 

Folly Island, too, was the only part of the southern 
states at which a vessel with cholera on board had ever 
arrived ; and the day after her arrival was the critical 
juncture at which the disease broke out there : if, then, 
we could for a moment suppose, that the appearance of 
cholera at that island had no necessary connection with 
the arrival of that infected vessel, the coincidence would 
be one of the most wonderful that ever occurred. 
Against the occurrence of one such coincidence, the 
chances would be at least one hundred thousand : — 
what then must we think when we find another such 
coincidence at Key West, another at Detroit, another at 
New Haven, one still more wonderful at Quebec, and 
twelve others (thousands might be cited) at different 
places ! Is it rational that we should still call them 
" coincidences 1" and if so, why not call it a coincidence 
when inoculation produces small- pox ? 



OBJECTIONS OF THE NON-CONTAGIONISTS. 



All the objections urged against the contagiousness of 
cholera, which are in the least degree worthy of refuta- 
tion, may be embraced under the six following : 

1. That this disease appears in places where it is impos- 
sible to trace it to its introduction. 

2. That the strictest quarantine regulations have often- 
times proved ineffectual in excluding it. 

3. That many persons may be exposed to its poison with- 
out contracting the disease. 

4. That its sudden increase and decline are incompatible 
with the laws of contagion. 

5. That it may be contracted more than once by the same 
individual. 

6. That there are no pustules, nor any other ostensible 
source from which the poison may be supposed to emanate. 

There is no particular fact, against the contagiousness 

of cholera, which may not be distinctly referred to one 

or other of these six general objections ; and, this being 

the case, it is only necessary to refute those objections 

in order to invalidate all the facts of the non-contagion- 

ists. I shall now endeavor to accomplish this object : 
o 



98 OBJECTIONS OF 

First. It will not be denied that cholera sometimes 
appears in places where it is impossible to trace it to its 
introduction ; but then the same is true of every other con- 
tagious disease : small-pox frequently appears, especially 
in inland towns, without the possibility of its being traced; 
and it is but seldom that measles, hooping-cough, scarla- 
tina or mumps, can be traced to the cause of their intro- 
duction. It would be wonderful, indeed, if in tracing 
these invisible poisons, we were able, in every instance, 
to mark their footsteps : for it is easy to conceive, that 
did they even consist of visible substances, we should 
oftentimes lose sight of them in the many secret paths 
by which they travel. Many, if not all of them, are 
capable, to a greater or less extent, of being conveyed in 
fomites ;* some may be communicated, like small-pox, 
by the convalescent, or persons laboring under such 
mild forms of the disease as will not prevent them from 
travelling ; while others, again, may possibly be im- 
parted by means of which we are at present entirely 
ignorant. f In addition to all this, it not unfrequently 
happens that municipal authorities feel it a duty to con- 
ceal the first manifestations of those diseases, and thereby 
increase still further the difficulty of tracing their intro- 
duction. 

* Fomites mean substances, of any kind, in which the poison of contagious 
diseases may be retained. There are many facts to prove that the poison of 
cholera may, under certain circumstances, be conveyed in fomites. Its great 
volatility, however, causes it soon to escape ; and this makes it difficult to con- 
vey it to any great distance in this manner. 

f It is by no means improbable that persons of strong constitution, who 
have been exposed to cholera poison, may, without having had the disease 
themselves, be able, by elimination, to communicate it to others. 



THE NON-CONTAGIONISTS. 99 

Of all contagious diseases, there is, perhaps, not one 
whose introduction is so frequently traced as that of cho- 
lera ; and this seems to depend on the great volatility 
of its poison, which renders it difficult to convey it in 
clothes, or other fomites by which it may be secretly 
introduced. The introduction of this disease is most 
easily traced when it makes transmarine visits : in those 
instances, it invariably appears first in a seaport, and is 
always coincident with the arrival of an infected ship. 
It did not visit the Mauritius, until the frigate Topaze 
arrived there with a sickly crew ; it did not visit Eng- 
land, until a vessel arrived at Sunderland on board of 
which some persons had died of the disease ; it did not 
show itself in North America, until a vessel arrived at 
Quebec on board which there had been many deaths ; it 
did not visit Folly Island, until the brig Amelia, with 
several patients on board, was wrecked there ; it did not 
visit Portugal, until a vessel arrived at Oporto on board 
of which several British officers had died. But we are 
told that, in some of these instances, the disease had 
appeared several days before the arrival of the ships ; 
and in others, that the persons first attacked, were per- 
sons who had had no intercourse with the sick: such asser- 
tions as these, however, will be duly estimated by every 
one who considers the number of miraculous coincidences 
which they involve. 

Cholera, in common with all other contagious diseases, 
is much more difficult to trace into large cities (unless 
when it crosses the sea) than into small towns and vil- 
lages. The reasons are obvious : besides the efforts 



100 OBJECTIONS OF 

made by boards of health to conceal or distort* facts, the 
great number of persons who may daily arrive from in- 
fected places, and have unrestricted intercourse with the 
citizens, must, in many instances, defeat the most vigi- 
lant scrutiny. 

In small towns and villages, and more especially in 
country houses, the difficulties are much diminished. 
In these, every person who may have been exposed to 
the poison is known — and the only obstacle that pre- 
sents itself is the introduction by fomites. This mode 
of introduction but seldom occurs in cholera, and the 
consequence is, that we are able, in almost every in- 
stance, to trace the disease whenever it visits these 
smaller places. 

It is unnecessary to pursue this objection further, as 



* The following notice from the Board of Health of Baltimore will serve, as 
a specimen of the manner in which such facts have been distorted : 

" N. B. — An editorial paragraph having appeared in a morning paper, stat- 
ing that three cases of cholera were reported to the Board of Health, as having 
occurred in Ruxton lane. It (therefore) becomes necessary to state in antici- 
pation of the weekly report, that the cases alluded to are known to the Board 
of Health ; and in their opinion, there is nothing to alarm the citizens. The 
first one was discovered on Saturday morning, having been intoxicated, and 
exposed to the night air two nights before ; he was immediately removed to 
the hospital, and is now in a very fair way of recovery. The second was an 
old man of eighty-four years of age, who had been ill with the premonitory- 
symptoms for some days, he was taken ill at 6 P. M., and his situation was 
unknown until the next morning, during which time he had no attendance 
whatever, he consequently died the next day. 

The third and last case, was that of a woman who was taken ill some time 
during Saturday night, and expired on Sunday night, (in about sixteen hours.) 
In this case, however, upon a post mortem examination, it was ascertained 
that she had received a blow, or kick upon her left side, which might have 
produced death, had there been no other cause. All three of these cases were 
colored persons of the most intemperate habits. By order, 

DAVID HARRIS, Secretary:' 



THE NON-C ONT AGIONISTS . 101 

it must appear evident, that if cholera is to be considered 
non-contagious because we are unable, in some instances, 
to trace it to its introduction, the contagiousness of 
small-pox, of measles, of hooping-cough, and other dis- 
eases must a fortiori be denied.* 

2. It is extremely unreasonable to urge against the 
contagiousness of cholera, the fact that cordons sanitaires, 
and other quarantine restrictions, have sometimes failed 
to exclude it; since the same is no less true of every 
contagious disease. There is no contagious disease 
which does not frequently elude the most rigid quaran- 
tine. Small-pox, whose contagiousness no one will 
deny, is excluded with greater difficulty than any other 
disease : notwithstanding the small number of persons 
who are susceptible of it, it can seldom be shut out, even 
from foreign ports ; and is perhaps never restricted, ex- 
cept by vaccination, after it has once entered a country. 
Indeed, before the discovery of vaccination, there was 
no possibility of resisting its invasions, whether made 
by land or sea. The great difficulty of excluding small- 
pox, very probably depends on the facility with which 
it may be conveyed in fomites. Cholera is very different 
in this respect ; it is seldom conveyed in fomites, and 



# We are oftentimes tauntingly asked, even by physicians, if we can tell how 
cholera was introduced into some places, and why it was not introduced into 
other places ; as though we should be able in every instance to account for its 
invisible movements ! What if we should ask how small-pox was introduced 
into Baltimore, into Charles county, and into several other places where it has 
appeared of late ; and why it was not introduced into Fredericktown, Hagers- 
town, and several other places where it has not appeared ; would they who 
disbelieve in the contagiousness of cholera be able to give us an explicit answer 
to those questions ? 



102 OBJECTIONS OF 

perhaps never to any great distance. The consequence 
is, that it is more frequently controlled by quarantine 
restrictions, than any other disease with which we are 
acquainted. It is true the cordons sanit aires of Prussia, 
although conducted with the utmost rigor, proved in- 
effectual in excluding it : but in this instance, as well as 
in many others, we are by no means certain that all in- 
tercourse with the infected was cut off; especially when 
we consider the very extensive frontier which it was 
necessary to guard ; and that during a time of war. It 
will hardly be contended that if small-pox, instead of 
cholera, had been prevailing as an epidemic on the fron- 
tiers of Prussia, that those cordons would have been 
successful in excluding it : and I am therefore at a loss 
to conceive why the non-contagionists should insist so 
much on a fact which is perfectly reconcilable with the 
laws of a disease which they themselves acknowledge to 
be contagious. 

The instances in which cholera has been shut out by 
quarantine restrictions are very numerous ; and might 
have been much more so, had the disease been univer- 
sally regarded as contagious. The kingdoms of Spain, 
Naples and Portugal* afford triumphant evidences of the 



* Portugal successfully resisted the incursion of cholera till a few months 
ago, when, as will appear by the following extract taken from a New York 
journal, the disease was introduced into Lisbon, by some troops destined for 
Don Miguel's army. 

" The cholera was carried into Lisbon by the troops sent out for Don 
Miguel's army ; several staff officers of which died on the passage. The dis- 
ease first made its appearance among those of the inhabitants visited by the 
troops. This intelligence was brought to Gibraltar by the Hyperion, the mas- 
ter of which inadvertently mentioned the fact, and he was forthwith ordered 



THE NON-CONTAGIONISTS. 103 

benefit of such restrictions. In neither of the two for- 
mer countries, has a single case of the disease as yet 
occurred; although their circumstances are in all re- 
spects, more favorable to its ravages than those of either 
Russia, England, or France. There is but one way in 
which this remarkable exemption can be accounted for, 
and that is, by the fact that those nations, more than any 
others in Europe, have persevered in the observance of 
rigid quarantine. Had North America viewed this mat- 
ter in a similar light, and acted with similar precaution, 
there can scarcely be a rational doubt that cholera would 
have still remained a stranger to us. Guarded on every 
side by an immense ocean, the western continent was 
peculiarly favored in its seclusion from this pestilence. 
It was scarcely possible, except by a rare concurrence 
of circumstances, to convey so volatile a poison as that 
of cholera across an ocean 3000 miles wide ; and we find, 
accordingly, that during an unrestricted intercourse, of 
more than two years, with infected cities, but three such 
concurrences took place. How easily, then, by the 
mildest quarantines, (by such quarantines as would have 
extended to rare instances only,) might this desolating 
pestilence have been excluded, forever, from the western 
world. I might, were it necessary, enumerate many 
particular instances in which cholera has been excluded 
by quarantine restrictions ; a few, however, will be 
sufficient. 



to Port Mahon. Two Portuguese vessels also arrived from Oporto, and were 
likewise ordered off. This is the first account of the cholera in either Portugal 
or Spain." 



104 OBJECTIONS OF 

The following is related by Kennedy, (page 204,) and 
I shall give it in his own words : 

" Taking advantage of the terrible example afforded 
in Mauritius, the Governor of Bourbon, a neighboring 
island, distant about two degrees, adopted sanitory pre- 
cautions to exclude the contagion. On the 7th of Jan- 
uary, however, a vessel called the Vic Var, from Port 
Louis, arrived off Bourbon, and had intercourse with the 
shore. 

" The cholera broke out several days afterwards in 
the town of St. Dennis. Nothing dismayed by this un- 
fortunate circumstance, the governor ordered cordons of 
troops to be posted, in order to cut off all communication 
with St. Dennis, the focus of the malady ; and a lazaretto 
was established for the reception of such persons as 
might be attacked. Cordons were also established for 
their preservation, at St. Susanna, St. Andre, and St. 
Benoit ; but in the consternation which seized the in- 
habitants of these parishes, they dispersed to seek safety 
in the interior of the country. The alarm created by 
the pestilence in Bourbon, and the vigorous proceedings 
of the governor, Baron de Mylius, may be conceived 
from the concluding sentence of the order of the day, 
which was, ' Surveillance ou la mort.' The consequences 
of these measures corresponded to the decision with 
which they were carried into effect. The cholera did 
not extend in Bourbon, as it had done in Mauritius, and 
the whole number of the persons attacked, scarcely 
amounted to a few hundred." 



THE NON-CONTAGIONISTS . 105 

The following extracts are from the work of Mr. 
Orton, one of our most respectable authorities : — 

"Separation and quarantine had been extensively 
practiced in one of the divisions of the Bengal army, 
and found very useful," (page 315.) 

" It was immediately opposed by quarantine, by the 
governments both of Persia and Russia, and considerable 
evidence exists of such measures having been partially 
effectual. Thus it appears that Shiraz was by that 
means saved from it for one season : the very same cir- 
cumstances occurred at St. Petersburg ; and various in- 
sulated bodies of people have been thus protected in its 
course through Russia. And the Pasha of Egypt is 
stated, by M. de Jonnes, to have by this means saved 
his country from its ravages," (page 336.) 

" In India no means of precaution against contagion 
appear to have been practiced, with the trifling excep- 
tions already stated ; and there are few bodies of people 
separated from the rest of society, by whom we might 
learn whether segregation would afford any immunity 
from the disease : but in every district there is at least 
one large jail, where of course great restriction is placed 
on intercourse ; and we certainly find, that in these com- 
munities, remarkable differences in the times of attack, 
from those of the neighboring population, or entire ex- 
emptions, are frequently observable. At Cannanore, 
on the Malabar coast, the disease appeared in a suburb 
next to Tellicherry, a neighboring town, where for some 
time it had been prevailing. For some days it lingered 
about the same spot, and then spread over the town ; 



106 OBJECTIONS OF 

but it never reached the small fort, (with I believe very 
few inhabitants,) a mile to the north, until two months 
afterwards ; when it broke out in the jail in the fort, and 
in the course of a week attacked twenty-nine of the pri- 
soners ; but never extended beyond the walls of the jail. 
A similar fact was observed during a second visitation 
of Cannanore. The disease got from thence into the 
jail in the fort of Tellicherry, but was almost entirely 
confined to it. So at Callicut, the disease broke out in 
the middle of October, but the jail did not suffer till the 
end of December. So at Madura, too, the disease ap- 
peared in the beginning of December, continued very 
prevalent in January, but did not reach the jail till the 
end of that month : from which time it attacked thirty- 
two, and destroyed ten of the prisoners in three weeks. 
When the epidemic prevailed first at Bellary, though it 
affected the inhabitants and troops generally, with some 
severity, the jail, containing five hundred prisoners, 
which stood detached and surrounded by a high wall, 
entirely escaped, except one case, which recovered. In 
Bengal, too, the same facts have occurred. ' In the 
great native jail at Alypoor, containing several thousand 
persons, scarcely a case appeared, whilst prisoners en- 
camped at the outposts, laboring in the sun, and sleeping 
in mud buildings at night, were very sickly ;' but this 
Mr. Jameson attributes to the airy situation of the jail. 
' So also the dry jail of the court of requests, containing 
four hundred prisoners, continued nearly exempt.' ' At 
Sharon, the only place left unaffected was the jail, which 
was clean, airy, and situated in an open space at a dis- 



THE NON-CONTAGIONISTS. 107 

tance from other buildings. The same favorable locali- 
ties nearly saved the Tirhoot jail.* * * So in Poornea, the 
lines of the provincial battalion and jail were quite ex- 
empt, when the disease was extensively fatal in the town. 
* # * j n F urruc k a k a cl ? the jail and the artillery barracks, 
the former containing six or seven hundred prisoners, 
had not a single case, whilst the levy corps suffered 
severely.' In Burdwan the same fact was still more 
remarkable. The disease is stated to have been there, 
' dreadfully destructive ;' and Mr. Jameson remarks : 
( It is singular, that during the period of the greatest 
mortality, the persons mostly affected were the sepoys 
and well-fed inhabitants of the town, whilst the convicts 
and debtors in the civil jail, remained healthy, until the 
rains, when they alone were attacked.' At Goruckpore, 
the disease was very severe, but the jail entirely escaped. 
Let it be remembered, too, that the class of persons 
thus so often exempted, were such as in other circum- 
stances were found most susceptible ; and when the dis- 
ease actually did get footing in the jails, it was often very 
destructive," (pages 339 and 340.) 

" In later periods of the progress of the epidemic, the 
preservative effect of insulation of bodies of people, has 
been very distinctly shown ; as in the clear facts stated 
by the London College of Physicians, of the colony of 
Sarepta and others, and the military school at Moscow 
being thus entirely protected from the disease, though it 
was raging around them. And nothing can be more 
strong than the following instance related by Dr. Kerau- 
dren. ' In 1822, the approaches of the cholera induced 



108 OBJECTIONS OF 

M. de Lesseps, the French consul in Aleppo, to take 
refuge, with all who chose to accompany him, in a gar- 
den at a little distance from the town. His asylum was 
surrounded by walls and a wide trench. It had but two 
doors or gates ; and while the scourge was abroad, he 
admitted nothing from the outside, without previously 
subjecting it to the precautions observed in the laza- 
rettos. This colony, of at least two hundred persons, 
had not a single case among them, while in eighteen days 
the cholera swept off four thousand persons in the town," 
(p. 341.) 

The facts here quoted, and which are corroborated by 
the most respectable testimony,* afford satisfactory proof 
that cholera may be excluded by sanatory restrictions, 
even by land. It will hardly be contended that the airy 
situation of some of those jails may account for their ex- 
emption, since it is notorious that cholera pays no respect 
to localities : nor will it be said that the inmates were 
protected by insusceptibility, since the disease generally 
made dreadful havoc after it once gained admission. 

Although the people of this country have, very gene- 
rally, acted in relation to cholera, as though it were an 
atmospheric, and of course an inevitable disease, there 
are, nevertheless, numerous instances in which the bene- 
fit of sanatory precautions has been made clearly mani- 
fest. It will be quite unnecessary, after what has been 
already advanced, to enumerate the many facts of this 
kind which have become publicly known. There is one, 

* Bengal and Madras Reports. 



THE NON-CONTAGXONISTS. 109 

however, of so striking a character as to demand notice. 
It is that of Folly Island. The information on this sub- 
ject is derived from the official report of the Intendant 
of Charleston, so that its accuracy may be relied on. 

Some time in October, 1832, the brig Amelia, with 
one hundred and eight persons on board, sailed from 
New York, where cholera was still prevailing, for New 
Orleans. On the sixth day out, sickness commenced on 
board, some dying in a few hours, and others lingering 
for several days. The physicians on board pronounced 
the disease to be cholera, and twenty deaths occurred at 
sea. On the 30th of the same month the brig was 
stranded on Folly Island, which is about ten miles from 
Charleston, and in a day or two afterwards the disease 
began to spread among the inhabitants of that island. 
All access to the crew and passengers, or the sick on the 
island, was rigidly interdicted by the civil authorities of 
Charleston, and no intercourse at all allowed, except by 
the written permission of the intendant, or one of the 
city wardens. By the authority of the governor, a de- 
tachment of the city guards was posted on the island, 
and two guard boats were directed to cruise by night, to 
prevent any evasion of this order. Several persons who 
had had intercourse with the passengers on board the 
infected vessel, were repulsed in attempting to enter 
Charleston, and having been sent back to the island, 
there died of the disease. The result of these rigid 
measures corresponded well with the decisive manner in 
which they were executed : the populous city of Charles- 
ton has remained up to this time a stranger to cholera ; 



110 OBJECTIONS OF 

although Folly Island, but ten miles distant, and with 
but few inhabitants, has been seyerely ravaged by the 
disease. 

3. It has been already stated that the poison of each 
contagious disease differs from that of every other, in its 
power of communicability ; so that there are no two 
which affect an equal number of persons. Of all the 
contagious poisons with which we are acquainted, there 
is none so powerful in this respect as the poison of small- 
pox ; and yet, powerful as it is, it will not affect every 
one who comes within the sphere of its influence. Many 
persons have, before inoculation was discovered, indus- 
triously endeavored to catch the infection, by frequent- 
ing the chambers of the sick, but without effect ; and yet 
these same persons, some months or years afterwards, 
have been attacked with the disease.* So it is, but to 
a much greater extent, with measles, hooping-cough, 
scarlatina and other contagious diseases; very many 
persons may be exposed to their poisons, whose insus- 
ceptibility will protect them from disease. 

Fortunately for mankind, cholera forms no exception 
to this rule ; but on the contrary, if properly understood, 
affords a more extensive immunity than almost any 
other disease. Besides those persons whose constitu- 
tional peculiarities will, under all circumstances, protect 
them from its attack, there is a large majority of those 
who really are susceptible, that will not contract the 
disease, even after exposure to its poison, provided they 

* Huxham's Treatise on Fevers, Small-pox, &c. 



THE N0N-C0NTAGI0NISTS. Ill 

avoid the causes which are known to develop it. In 
this particular, cholera differs very much from all other 
diseases, whether local or contagious : for, although it is 
probable that there is no specific disease whatever, whose 
development may not be, in some degree, assisted by the 
supervention of exciting agents, it is very certain that 
there is none in which this assistance is so clearly mani- 
fest as in cholera. An extensive observation of facts will 
justify us in the inference, that of ten persons impreg- 
nated with the poison of cholera, not one may ever have 
the disease, provided they avoid all exciting causes ; 
while, on the other hand, not one of the ten will escape 
it, if, through ignorance or negligence, they subject 
themselves to exciting agents. They who are sufficiently 
enlightened to know the exciting causes of cholera, and 
are at the same time sufficiently prudent to avoid them, 
have but little to dread from exposure to its poison. 
But unfortunately the number of those is as yet com- 
paratively small, and this is one reason that the disease 
is so extensive in its ravages. 

It is then admitted by the contagionists, that consti- 
tutional insusceptibility, together with an avoidance of 
exciting causes, will protect many persons from the poi- 
son of cholera, even should they have been exposed to 
it in its most concentrated form ; — and in this they con- 
tend there is nothing which should militate against their 
doctrine, since the same is true of other contagious dis- 
eases. The non-contagionists, however, seem to think 
differently; and one of their principal reasons for assert- 
ing that the disease is never communicated, may be found 



112 OBJECTIONS OF 

in the fact that it is not always communicated ! Nothing 
is more common than to hear them (even physicians) 
say, that cholera cannot be contagious, because if it 
were they must certainly have taken it, as they had fre- 
quently visited the bedsides of the sick ! Are they not 
aware that some of them might have visited patients 
with small-pox,* — that many of them might have visited 
patients with measles, — and that a great many of them 
might have visited patients with scarlatina, — without 
contracting those diseases ? and if so, why should they 
make this an objection to the contagiousness of cholera ?f 
Besides, they ought to consider that if the disease were 
not contagious, the difficulty of accounting for their 
exemption would be much greater than it is, as they 
would, in that event, be constantly breathing a poison- 
ous atmosphere without being the least affected by it, — -- 
Were the disease other than contagious, every breath 
they drew, from morning till night, and from night till 
morning, would drug them with its poison : and it would 
certainly be much more wonderful that the system 
should be able to resist a deleterious agent, under those 
circumstances, than under transient exposure. — That 

* Vaccination itself often fails. 

f Persons have swallowed the " black vomit" of yellow fever, the " rice- 
water" of cholera, have slept in the beds of the sick, worn their clothes, and 
performed a variety of other disgusting experiments, with a view to test the 
contagiousness or non-contagiousness of those diseases. Such experiments, 
however, prove nothing on either side : for, if they should fail to communi- 
cate the disease, the contagionist will insist that the experimenters were insus- 
ceptible ; or else that the poison has a different source. If, on the other hand, 
the disease should be communicated in every instance, the non-contagionist 
will find a ready explanation in the " coincidence" of either " local origin," or 
" atmospheric intemperament." 



THE NON-CONTAGIONISTS. 113 

out of a population of one hundred thousand persons, 
who, were constantly and equally exposed, there should 
be but five thousand* (one out of twenty) affected, would 
certainly be more difficult to account for than that a few 
hundreds, who had been occasionally exposed at the 
bedside, should have escaped. 

The contagionists do not contend that cholera may be 
communicated to every one, — nor do the non-contagion- 
ists admit that it may be communicated to any one :f — 
it is, therefore, only required of the former, to prove 
that it has been communicated to some; while it is the 
duty of the latter, to disprove that it has been commu- 
nicated to any. It is idle, then, for the non-contagionists 
to state those cases, in which all will admit that the dis- 
ease has not been communicated ; since no amount of 
such negative evidence would be sufficient to disprove 
one of those positive facts upon which the contagionists 
insist. 

Besides the unequivocal facts already stated, and 
which should, of themselves, place the contagiousness of 
this disease beyond the power of cavil — there are others 
which, although somewhat equivocal in their character, 
go far, nevertheless, towards establishing this truth. I 
shall only advert to a few them : When cholera enters a 

* This was the maximum of the cases in Baltimore. 

« 

f There is a sect who contend that cholera is not only contagious, but atmo- 
spheric also ! That is to say, its poison may be communicated from 'one human 
body to another, besides -being generated in the atmosphere ! This is certainly 
a wide view of the subject, and whoever undertakes to defend such doctrine, 
needs be well fortified with argument, as it will be incumbent in him to answer 
the objections on both sides of the question. 
H 



114 OBJECTIONS OF 

house, it generally attacks several of its inmates, and 
not unfrequently sweeps off every member of the family; 
and this, too, in vicinities where other families totally 
escape it. This, as a general fact, is notorious in every 
country that cholera has visited, and has never been 
denied, even by the non-contagionists ; I leave it with- 
out comment. 

It may be seen by reference to statistics on the subject, 
that physicians, nurses, undertakers, and grave-diggers 
have, in many instances, suffered much more from 
cholera, in proportion to their numbers, than any other 
class of people. Dr. Burrel says, (page 9 of the Bom- 
bay Reports,) " I am cautious in reporting the cholera 
not infectious (contagious) : almost every attendant in 
the hospital, during the short space of six days has had 
the complaint ; and there are about thirty attendants 
attached to the establishment. The admissions from 
the regiment bear no proportion to the number of the 
attendants who have been taken sick." Chapman, 
England, Train, and many other respectable surgeons in 
India, state similar facts in their reports to government; 
and when we come to make particular investigations on 
this subject, we find such to be the case much more fre- 
quently than is generally represented. 

If, instead of counting the number of attendants who 
die of cholera, we extend our inquiries to those who are 
attacked with the disease, we shall be able to form a 
more correct estimate of its contagious character ; for it 
is well known, that it can be almost invariably cured if 
treated judiciously in its forming stage ; and that none 



THE NON-CONTAGIONISTS. 115 

are so likely to attend to it, in this stage, as medical men 
and their subalterns. We are told, for example, that 
the physicians of Baltimore suffered but little from 
cholera, because, forsooth, there was but one of their 
number who died of the disease. But on inquiring into 
the number who were seriously attacked by it, I am, my- 
self, able to count thirty, and in all probability the num- 
ber was much greater. Supposing, however, that there 
were no more than thirty attacked, and that the prac- 
ticing physicians of Baltimore amounted altogether to 
one hundred and forty, which was the utmost ; this will 
leave a proportion of more than one to five of their 
whole body who were affected with the disease. How 
was it with the citizens in general ? Had one out of 
every five an attack of cholera ? if so, there must have 
been twenty thousand cases in the city ; instead of this, 
however, it is ascertained that there w r ere not five thou- 
sand altogether. Thus it appears, at the lowest calcula- 
tion, that the number of physicians attacked in Balti- 
more, was as four to one of any other class of citizens ; 
and this, too, in a city where they are said not to have 
suffered particularly from the disease ! 

In the Baltimore alms-house, several of the attendants 
died, and nearly all the rest, medical as well as menial, 
saved themselves by the timely use of medicine in the 
premonitory stage. 

If we estimate the proportion of attendants who actu- 
ally die of cholera in the country, we shall find that, in 
many places, it exceeds five hundred to one of any other 
class of inhabitants ! 



116 OBJECTIONS OF 

It may be well to notice in this place, some facts 
which are stated to have occurred, at different times, 
among the troops in India ; and which, at first view, 
would seem to form a strong objection to the doctrine of 
contagion. These facts, though numerous, are all of the 
same character ; and one explanation will, therefore, 
serve for the whole. 

There has prevailed in India, from time immemorial, 
a local disease called cholera. This disease is always 
confined to low jungly districts, and never appears even 
in them, except during the hot and rainy seasons of that 
climate. Although, in most respects, it closely resembles 
the disease now under consideration, yet there is nothing 
in its character which ever led to the suspicion that it 
was contagious. Like diseases dependent on malaria, it 
is uniformly extinguished by cold, and never, in any in- 
stance has it been known to spread beyond the sphere of 
its local origin. When the contagious pestilence which 
is now among us, made its appearance at Jessore, it was 
first mistaken for the local cholera. A little further 
observation, however, soon decided that it was an en- 
tirely new disease ; for, besides being more malignant 
than that which heretofore prevailed, it was found to 
pay no respect either to season or locality. Radiating 
from Jessore, as from a centre, it soon diffused itself in 
every direction, visiting districts where cholera was be- 
fore unknown, and prevailing in seasons which had never 
failed to extinguish the local disease. 

The existence of two diseases, so closely resembling 
each other, caused them to be often confounded ; and 



THE NON- CONT AGIONISTS. 117 

this has given rise to many contradictory, and apparently 
anomalous facts. It has been observed, for instance, 
that some bodies of troops, infected with cholera, have 
spread the disease in all the towns and villages through 
which they passed ; while others, similarly affected, have 
commingled with healthy troops without communicating 
a single case of the disease. These, and all such facts 
may, however, be easily reconciled by supposing that in 
the former case, the troops were laboring under the con- 
tagious cholera — and that in the latter they had, as is 
common, carried in their systems from some infected 
districts the seeds of the local disease. 

What makes this explanation the more satisfactory is, 
that facts of this description have happened no where 
except in India ; nor are they to be met with even in 
that country, except during the hot and rainy seasons, 
and in the vicinity of those districts where the local 
cholera is known to prevail. 

4. In contemplating the innumerable effluvia which 
emanate from the different species of the vegetable and 
animal kingdoms, we find them as various as are the 
sources whence they issue : some fragrant, some fetid, 
some pungent, some mild, some extremely volatile, 
others extremely fixed, and others again, of which our 
senses take no cognizance, but which several of the in- 
ferior animals can appreciate. So much are they varied, 
that notwithstanding their infinite number, there are no 
two in all Nature which are known to be precisely alike in 
a single attribute. How unphilosophic is it, then, to argue 
that any two of them should be precisely alike in a 



118 OBJECTIONS OF 

single manifestation ! Yet such is the argument of the 
non-contagionists, when they tell us that " the sudden 
increase and decline of cholera are incompatible with 
the laws of contagion." What do they mean by the 
laws of contagion ? The laws of small-pox are all dif- 
ferent from the laws of measles ; and the laws of measles 
from those of mumps, scarlatina, plague, syphilis and 
every other contagious disease with which we are ac- 
quainted ; why then should not cholera, like other con- 
tagions, have its own laws ? Mumps spreads less rapidly 
than small-pox, small-pox than measles, measles than 
cholera, cholera than influenza ; and there is no reason 
why some disease may not hereafter appear, which will 
spread more rapidly than any of them. 

If we were acquainted with all the contagions that can 
be generated in the human body, and had ascertained 
that it was impossible for any one of them to become 
generally diffused over a city in five weeks, we should 
be justified in asserting that the increase and decline of 
cholera were incompatible with contagion, but not 
otherwise. 

If we take, as a familiar example, the effluvium which 
emanates from goats, and suppose it a poison capable by 
communicability of producing cholera, it is easy to con- 
ceive that it might be diffused over a large city, even in 
a much shorter period than five weeks ; more especially 
if, like cholera, its latent period were a short one.* 



* By the latent period of a poison is meant the time it will remain in the 
system before developing the disease. This period is in many diseases very 
indefinite, and we do not know any two in which it is precisely the same. 



THE NON- C ONT AGIONISTS . 119 

How absurd it is, then, to object to the contagiousness 
of cholera on the ground of its sudden increase and 
decline ! 

5. It is by no means ascertained that persons who 
have had cholera once, in its true form, and who have 
completely recovered from its effects, are liable to a 
second attack. We have the most respectable authori- 
ties to show that immunity from a second attack of this 
disease is as certain as from any other contagion, not 
even excepting small-pox. Orton (page 444) says, 
" The same immunity from secondary visitation was 
observed in every quarter in which the epidemic pre- 
vailed, and we should perhaps be not far wide of the 
truth, were we to affirm, that of the many myriads 
attacked, the returns of the whole country do not afford 
a score of well authenticated cases of a recurrence of the 
disease, after the removal of the debility, and every other 
consequence, of the primary attack." 

But even admitting that cholera may be contracted 
several times by the same individual, there can be no 
good reason for urging this as an objection to its con- 



Its general range, is, however, between six and twenty-one days. In cholera 
it is shorter than in any disease with which we are acquainted, besides being 
extremely irregular. In this disease, the poison does not, in many instances, 
require more than six hours for its development ; although it is sometimes pro- 
tracted beyond the period of two weeks. Even this fact has been caught at 
by the non-contagionists, and affords us another specimen of the logic em- 
ployed against the contagiousness of cholera. Their argument is this : the 
latent period of small-pox is from six to twenty-one days, and it is a conta- 
gious disease ; but the latent period of cholera is from six hours to twenty 
days, therefore cholera is not contagious ! Hydrophobia is contagious, and 
yet there is no regularity in its latent period. It is sometimes developed in 
nine days, at other times not till nine months ! 



120 OBJECTIONS OF 

tagiousness, since every contagious disease differs, more 
or less, from every other, in the immunity which its 
primary attack affords. Measles affords less immunity 
than small-pox ; scarlatina still less than measles ; and 
syphilis affords none at all. 

Although small-pox gives a greater immunity than 
any other disease, there are, nevertheless, many in- 
stances in which it has been contracted a second time. 
Indeed, we are informed by Araan, an Alexandrian 
physician who wrote in the seventh century, that small- 
pox at that early period of its history, was usually con- 
tracted a second, and even a third time by the same 
individual. 

6. We are told that there is no ostensible source 
whence the poison of cholera may be supposed to ema- 
nate, and that, therefore, the disease is not contagious : 
or, in other words, that because we cannot see the source 
of an invisible poison, there can, therefore, be no in- 
visible poison ! Cholera, it is true, has no pustules from 
which its poison may be supposed to emanate ; but then 
it has a clammy exudation, which bedews the whole 
surface of the body, and which is very generally attended 
with a peculiar odor. Why may not its poison proceed 
copiously from this source ? and why may it not also 
have its origin in these watery evacuations, which are 
characteristic of the disease ?* But even were there no 

* I am not aware that any experiments have yet been made to determine 
whether cholera may be communicated by inoculation, with either the exuda- 
tion which bedews the surface of the body, or with the characteristic rice-water 
discharge ; but I think it not at all improbable that it may yet be shown that 
cholera, as well as some other contagious diseases, may be communicated by 
inoculation. 



THE NON-CONTAGIONISTS . 121 

cutaneous exudation, or rice-water evacuation, still it is 
easy to conceive that its poison might be exhaled from 
the whole superficies of the body. How is it with mumps 
and hooping-cough — are they not contagious ? and if so, 
where are the sources of their poisons ? 

Such are the general objections of the non-contagion- 
ists; and I trust it will be decided by every impartial 
mind, that the facts and arguments which have been 
here advanced, afford satisfactory refutation of them. 
Several of those objections apply against the contagious- 
ness of small-pox with greater force than against that of 
cholera ; and nearly all of them are of ■ so frivolous a 
character as to have been unworthy of notice were it not 
for the high authorities by which they are reiterated. 

We frequently hear it said, that " the facts are strong 
on both sides of this question." This, however, is an 
assertion to which the contagionist can by no means 
subscribe : there is no well authenticated fact which 
may not be reconciled with contagion ; while there are 
thousands which can be reconciled with no other doc- 
trine. The facts of the non-contagionists are all included 
under the six general objections which have been just 
considered ; and if these objections have been all invali- 
dated, it is impossible there can be strength in any of 
the particular facts which they embrace. 

Before the non-contagionist can take ground as re- 
spectable as that which the contagionist now occupies, it 
will be necessary for him not only to invalidate every 
one of the many positive and undisputed facts upon 
which the contagionist insists, but he must also produce 



122 OBJECTIONS OF 

a non-contagion theory, which shall be supported by as 
great an amount of positive and negative evidence as 
now sustains the doctrine of contagion. As it is, the 
cases are very different : there are in support of conta- 
gion^ innumerable facts of a positive character, which 
the non-contagionist cannot deny, and which he has 
failed to invalidate. On these facts the contagionist has 
built a theory, by which he is enabled to explain nearly 
all the progressive phenomena of cholera ; and against 
the truth of which the non-contagionist, after fifteen 
years' observation, has not been able to produce one 
valid objection. 

On the other hand the non-contagionist, after having 
on a few partial facts, (all of which can be reconciled 
with contagion,) raised hypothesis after hypothesis, till 
conjecture itself became exhausted, has at length aban- 
doned the subject as one of "deep mystery;" and now, 
after the disease has been fifteen years travelling, ac- 
knowledges himself as ignorant of its mode of progress 
as he was when it first appeared ! From this it will be 
seen, that the non-contagionist has no theory of his own, 
and that his whole occupation consists in endeavoring to 
subvert that of the contagionist. 

If we even suppose that the non-contagionist had suc- 
ceeded in all he aims at — that is to say, if he had not 
only substantiated his objections against contagion, but 
had invalidated every positive fact that is brought in 
support of it, he would, after all, have only proved to us 
that contagion is one way by which cholera does not 
advance ; and thus, after fifteen years labor, he would 



THE NON-CONTAGIONISTS . 123 

but have convinced us of our ignorance, without having 
made one step towards enlightening it ! But even this 
much he has not accomplished ; and his fifteen years' 
labor, if not absolutely mischievous, has, at all events, 
been productive of no good : for he has given us no new 
theory; and the increasing number of contagionists 
proves clearly, that in his efforts to subvert the old one, 
he has entirely failed. 



-\ 



EVILS OF THE DOCTRINE OF NON-CONTAGION. 



The evils which result from the very general preva- 
lence of the doctrine of non-contagion, are so extensive 
in their bearings, and of so manifold a character, that a 
volume would not suffice for their discussion. It is un- 
der the shout of non-contagion, that cholera achieves its 
most frightful victories ; and, unfortunately, this is the 
shout with which the pestilence has been greeted at 
almost every step of its desolating march. 

I shall merely glance at a few of the more prominent 
of these evils, and such only as have been manifested in 
our own country. 

The first, and most momentous of them is, the intro-. 
duction of the disease into the western continent ; and 
that this immeasurable calamity is attributable to the 
error of non-contagion, hardly admits of a rational doubt. 
Had the brig Carricks arrived on the coast of Spain or 
Italy, after having lost forty-two of her passengers by 
cholera, it is very certain that the remainder would not 
have been permitted to land till after they had under- 
gone a purification of at least forty days. At Quebec, 
however, this infected vessel was allowed to land one 
hundred and thirty-three of her passengers on Grosse 
Isle, as soon as she arrived ; and the consequence was, 



OF NON-CONTAGION. 125 

that shortly afterwards the disease broke out both there 
and in Quebec. It must appear evident, from this cir- 
cumstance, that the authorities at Quebec made nothing 
more than a mere feint to resist the incursion of cholera. 
Had they been fully persuaded of the truth of its conta- 
giousness, it is not credible that they would have allowed 
these passengers to land until all chance of danger had 
been removed : and if they did so, knowing the disease 
to be contagious, such culpable negligence would have 
merited the execration of the whole western hemisphere. 
How many thousands of valuable lives might have been 
saved, and what desolation of every kind averted, had 
this infected vessel been only subjected to such quaran- 
tine restrictions as are every day practiced in Spain and 
Italy ! Surrounded as we are by immense oceans, it 
was not necessary to cripple commerce in order to shut 
out this pestilence ; for, during two years of most exten- 
sive intercourse with Europe, but three vessels arrived 
in North America on which it was necessary to impose 
rigid quarantine ; and these were all passenger- vessels. 
In South America, to which there is but little emigration 
from Europe, we do not hear that a single vessel has 
arrived, on board which persons had died of cholera ; so 
that the whole western world presents, during two years 
intercourse with infected places, but three instances in 
which there was danger of importing the cholera. Two 
of these occurred in a city to which emigration was most 
extensive, and in that city the disease first appeared. 
The conclusion is irresistible, that if these three vessels 
had been placed under rigid quarantine, the pestilence 



126 EVILS OF THE DOCTRINE 

would have, to this day, remained a stranger to our 
shores. 

One would have supposed that the manner in which 
the cholera was introduced into Quebec, if it did not 
completely unfold to the non-contagionists the error of 
their doctrine, would have at least led them to act to- 
wards the disease as though it might be contagious : 
such, however, was not the case ; for no sooner had this 
pestilence landed on our continent, than a hue and cry 
was raised against the idea of its contagiousness, as- one 
fraught with mischief. Nearly every editor in the coun- 
try united in this cry, and the consequence was, that the 
dreadful stranger was permitted to enter almost every 
town under the mask of non-contagion. It is true, after 
the disease had spread itself extensively, some partial 
efforts were made to resist its further diffusion; such 
efforts, however, were then too late : it had already 
posted itself at too many points, and the scattering tide 
of emigration afforded too many facilities to its onward 
march. 

But although it might have been impossible to resist 
the progress of cholera, after it had once obtained a firm 
foothold in our country, it is very certain that much 
might have been done towards checking its ravages, had 
it not been for the erroneous views of the non-contagion- 
ists. The experience of fifteen years seemed entirely lost 
on them : the local-origin sect had never seen cholera, in 
all its travels, pay the least regard to cleanliness,* yet 

* When filth is so extreme as to exercise a debilitating influence on the sys- 
tem, it will no doubt serve as a predisposing cause to cholera, as well as to all 



OF NON-CONTAGION. 127 

cleanliness was almost the only weapon with which they 
opposed it ! The atmospheric sect had never seen the 
disease prevail, as an epidemic, in the country ; yet did 
they warn the citizens against leaving the infected towns ! 
Every one had noticed that cholera was most destructive 
in condensed crowds, yet their hospitals were so con- 
structed as to crowd thirty or forty patients in a single 
room ! 

So far from having made judicious efforts to check 
this disease, it would appear, at least to the contagionist, 
as though every thing had been done with a view to 
promote its ravages. Those funds which should have 
been employed in providing insulated hospitals, con- 
structed so that each patient would have a separate 
apartment, were senselessly squandered in sweeping the 
dust out of the streets, after they had been already suffi- 
ciently cleansed; and this, too, when experience had 
instructed us that the cleanest streets were oftentimes 
severely ravaged, while the filthiest were entirely 
spared.* 

After the disease entered a city, it would seem as 
though nothing was neglected that could assist its propa- 
gation : the sick, instead of having been provided with 

other diseases. No degree of filth, however, will produce this disease, nor will 
any degree of cleanliness avert it : its whole history proves that the cleanest 
palaces are as amenable to its ravages as are the filthiest hovels ; provided only 
that the inmates ne equally susceptible. 

* It is certainly desirable, both on account of health and pleasure, that the 
streets should be kept, at all times, as clean as possible. But the evil here 
complained of is, that cleanliness should have been looked to as the summum 
bonum, while means infinitely more important were but indifferently attended 
to, if not wholly neglected. 



128 EVILS OF THE DOCTRINE 

suitable hospitals, such as they would have been glad to 
retreat to, were left scattered about in their own dwell- 
ings, where each one became a fountain of disease. 
Multitudes who were well, flocked without the least 
necessity, to the bedsides of the sick ; afterwards com- 
mingled with those who were more prudent than them- 
selves — and seemed actually industrious in sowing the 
seeds of death. The dead, instead of having been im- 
mediately and privately interred, were generally kept 
the usual time in state ; were then, not unfrequently, 
carried into crowded churches, and afterwards numerously 
attended to the grave. While all this was going on, 
and while the atmosphere of the city, from the number 
of the dying and the dead, was becoming every day more 
and more contaminated with the poison, the citizens 
were besought — tc as they valued their lives" — to stand 
their ground, and by no means retreat to the country ! 
They were told, as a reason, that the disease would pre- 
vail just as much in the country as in the towns; besides 
the greater difficulty they would incur of obtaining phy- 
sicians ! Numbers of our most valuable citizens were 
governed by this advice ; and numbers of them paid the 
forfeit of their lives. There were many thousands, how- 
ever, who took better counsel. They were governed by 
their own common sense. They saw the city mourning 
in the gloom of pestilence, while the country w x as smiling 
in the enjoyment of health ; they chose the latter, and 
thus saved their lives. It is true that some few, out of 
many thousands, died shortly after they had reached the 
country ; but in all such instances, the deaths occurred 



OF NON- CONTAGION. 129 

in so short a period after their removal, as to render it 
evident that they had carried with them the seeds of the 
disease. 

It is well known that the proportion of deaths in hos- 
pitals has been, every where, much greater than in pri- 
vate practice : so dreadful has been the mortality in those 
institutions, that popular prejudice has oftentimes been 
strongly excited against them ; and, hv some instances, 
infuriated mobs have threatened them with destruction. 
This extraordinary mortality is variously accounted for : 
some attribute it to the progress which the disease has 
made before the patients can reach the hospital; some 
to the bad consequences of removing them from a dis- 
tance ; while others contend that it is owing to the de- 
praved habits, and broken down constitutions of the class 
of patients who are generally taken there. Experience 
proves to us, however, that all these circumstances com- 
bined would be insufficient to explain the fact : for we 
find in camps, where the patients are vigorous in consti- 
tution, and regular in their habits, where attendance is 
prompt, and where removal is unnecessary, that the 
same dreadful mortality prevails as in hospitals, jails, 
and alms-houses. In short, we find this to be the case 
in all crowds whatever, whether situated on land or sea: 
and the rational inference is, that it is the crowd that 
occasions it. 

If the malignancy of cholera bear any proportion to 
the quantity of contagion imbibed, it is easy to conceive 
that the copious and concentrated poison, to which the 
patients in our hospitals were constantly exposed, must 



130 EVILS OF THE DOCTRINE 

have rendered their recovery extremely difficult, even 
under the most skillful treatment. It was not uncom- 
mon to see thirty or forty of them in a single room ; 
their beds not more than three feet apart, and the win- 
dows carefully closed, as if to prevent the escape of the 
accumulating poison ! 

These are but a few of the practical evils of the doc- 
trine of non-contagion ; yet they are sufficient to show 
that, like all other errors, its operations are mischievous 
as far as its influence extends. 

We are told that the doctrine of contagion is full of 
evils ; but its evils, even admitting it were false, would 
be only as dust in the balance, when compared with 
those of the doctrine of non-contagion, supposing the 
latter to be false. Were the doctrine of contagion false, 
the worst that could result from its prevalence would 
be the losses and privations consequent to commercial 
restrictions, together with occasional desertions of the 
sick ;* whereas, if the doctrine of contagion be true, that 

* The idea that the sick would be generally deserted, were cholera univer- 
sally recognized as contagious, is a mere bug-bear. Such was not the case in 
small-pox, even before the discovery of vaccination ; and such never can be 
the case, in any disease, unless human nature shall change its character. We 
are not acquainted with any poison, contagious or otherwise, of which there 
are not many persons insusceptible — and this is especially the case with cho- 
lera. It has been already stated, that out often persons exposed to its conta- 
gion, it is probable that, by proper care, the disease will not be developed in 
more than a single instance. Besides this, we are informed by the most re- 
spectable authorities, that they who have had the disease once, are insuscep- 
tible of it a second time. But even were all susceptible of cholera, there 
would still be found a sufficient number whom ties of kindred, feelings of be- 
nevolence, or motives of interest, would prompt to perform the necessary 
offices for the sick. If, however, there were no such persons to be found, still 
that principle would be an unjust one, which would blindfold men — in order 



OF NON-CONTAGION. 131 

of non-contagion must be productive of evils the most 
calamitous that can befall our race. Human sufferings 
immeasurable, and deaths by myriads, must result from 
its operation. Almost every town may charge it with 
the loss of some of its most valuable inhabitants ; and 
there is scarcely a family that may not ascribe to it the 
death of a relative or a friend. 

It is asserted, too, that contagion is a frightful doc- 
trine ; but it is certainly a doctrine of consolation when 
compared with that of non-contagion : the one points out 
to us clear paths, by pursuing which, the danger may be 
avoided ; the other does not even flatter us with the 
hope of a refuge. The contagionist assures us that it is 
only by exposing ourselves within certain peripheries, 
that we can become victims of cholera ; and that even 
within these peripheries there are many chances of 
escape. The non-contagionist affirms that we are no 
where secure;* that town and country are equally ob- 
noxious to the " mysterious" destroyer ; and that any 
attempt to escape it is but a flight in the dark. Conta- 



that they might discharge those duties. There would certainly be much less 
evil, and far more morality, in allowing one man to die through neglect, than 
in occasioning twenty to die through deception. 

# The following extract from a work on cholera, lately published in New 
York, affords a pretty fair specimen of the dogmatism by which multitudes 
were no less terrified than deluded : 

" When cholera appears in any place, and begins to spread, it is utterly 
vain to remove, with the hope of fleeing from the disease. The remote causes, 
which we have placed in the air, have already excited the predisposition in all 
who have inhaled it ; and however rapidly they may leave the city, or however 
distant they may flee, they carry with them the epidemic constitution or the 
predisposition." 



132 EVILS OF THE DOCTRINE 

gion, therefore, holds out to us an asylum ; while non- 
contagion abandons us to our fate. 

It is much to be regretted that the non-contagionists, 
although professedly ignorant of the mode by which 
cholera proceeds, should, nevertheless, have undertaken 
to speculate on its future movements. Their predictions, 
on this subject, were of course nothing more than mere 
guesses; and yet these guesses were made in such a 
tone of confidence, that multitudes were deceived by 
them. Before cholera reached our shores, it was boldly 
asserted, by some of them, that it would never cross the 
Atlantic ; others admitted that it might cross the Atlan- 
tic, but that if it did, it would come to us so modified 
by the pure air of the ocean as to do us but little mis- 
chief. After the pestilence did arrive on our continent, 
and presented itself in its own true character, we were 
told that its ravages would be confined to a " certain 
vein in the atmosphere," and that it would never reach 
as far south as New York ! It did reach New York ; 
and it was then loudly asserted that filth was the cause 
that produced it, and that places which were clean would 
escape it. It ravaged places which were clean, as well 
as those which were not so, and it was then said that its 
presence depended on heat, moisture, or some other con- 
dition of the weather ! It would be tedious to enumerate 
the many unfounded predictions to which non-contagion 
has given rise. But unfounded and contradictory as 
they were, some of them still continue to occupy the 
public mind, and to influence public measures ; and 
this, too, after numerous facts have occurred which 



OF NON-CONTAGION. 133 

demonstrate their falsity. It is such predictions as these 
that have bewildered the public mind, deceived public 
expectation, and brought merited opprobrium on the 
medical profession. 

Among the contagionists there are no sects — and con- 
sequently there are no contradictory predictions. They 
all agree that cholera may visit any place, provided 
there be sufficient intercourse to convey it ; and that it 
can visit no place unless such intercourse subsist. They 
all agree that cholera will every where manifest pre- 
cisely the same character ; and that it will be modified 
by no circumstance whatever, except the susceptibilities 
of its victims. Hence it will be seen, that the conta- 
gionists could not possibty have distracted the public 
mind ; and the whole history of cholera bears witness 
that they have never deceived it. 



PREVENTION OF CHOLERA. 



The most important knowledge in relation to any dis- 
ease is that which leads to its prevention : the knowledge 
that small-pox may be prevented by vaccination, is of 
infinitely more value to mankind, than if a remedy had 
been discovered by which that disease might be inva- 
riably cured. So with cholera : if it be really conta- 
gious, and if the character of its contagion be such as I 
have described it, its prevention may be carried even to 
a much greater extent than that of small-pox, if not to 
its total extinction ; and the knowledge of such a fact is 
vastly more important, than if we had discovered an 
infallible cure for the malady. 

Under the presumption that cholera is contagious, and 
that its contagion is endowed with the properties which 
I have already assigned to it, I shall make some brief 
remarks on what I conceive to be the most efficient 
means of prevention. 

In order to guard against the general incursions of 
cholera, as well as against its individual attacks, it is 
necessary to be particularly mindful of two facts : one is, 
that the poison which produces this disease has its source 
in the human body only; the other, that this poison is, in a 
majority of cases, incapable of producing the disease, un- 
less assisted by an exciting cause. The prevention of cho- 
lera may, therefore, be considered under two heads : first, 
the means of avoiding its poison ; secondly, of obviating 
the effects of that poison after it has entered the system. 



PREVENTION OF CHOLERA. 135 

1. The fact that cholera is a contagious disease, will 
admonish every community, as well as every individual, 
of the propriety of avoiding all unnecessary exposure to 
its poison ; and it therefore becomes an object of great 
moment to determine, what are the most efficient means 
of guarding against such exposure. The employment 
of quarantine restrictions, with a view to prevent the 
incursions of this disease, is, at the present time, looked 
upon as nothing short of medical barbarism ; and when 
we consider how injudiciously such restrictions have been 
generally employed, we cannot be much surprised at the 
opprobrium which attaches to them. In many instances, 
they have been rigidly enforced under such circumstances 
as scarcely offered a hope of success ; while in others, 
their want of success may be justly attributed to the 
inefficient manner in which they have been executed. 
In Prussia, for example, an effort was made to guard, 
by the most rigid restrictions, a whole frontier against 
the invasion of cholera ; and that during a time of war : 
while in North America, where the prospect of success 
was most favorable, the disease w T as opposed by nothing 
more than a nominal quarantine. It is obviously a 
great error to employ sanatory restrictions at all, except 
where there is a rational prospect of success; and, where 
such prospect does exist, the error is still greater not to 
enforce those restrictions with the utmost rigor. 

Were I asked, under what circumstances I would be 
disposed to employ quarantine restrictions in relation to 
cholera ; I should answer : first, in all insulated places ; 
and especially such as are surrounded by an extensive 



136 PREVENTION OP CHOLERA. 

sea : and secondly, in every other situation where the 
intercourse with infected districts is of so limited a 
character, as to allow it to be completely cut off without 
subjecting the inhabitants to serious inconvenience. 

Should cholera ever become extinct on our continent, 
(and we have much reason to infer that it may,)* it will 
be in our power, by judicious quarantines, to guard 
against its return, even without imposing on commerce 
any serious restrictions. It will, for reasons already 
stated, be entirely unnecessary to subject to quarantine 
laws, any other vessels than those on board of which 
persons have been sick of the disease ; and such vessels, 
from the fewness of their number, may be placed under 
the most rigid restrictions, and yet occasion but a very 



* The opinion here expressed, that cholera would probably become extinct 
on this continent, was verified. There was not a case of this disease known to 
exist in any part of the United States, in 1849 — previously to the arrival at 
New Orleans of a passenger ship from Havre, with cholera on board. Two 
passenger ships left Havre about the same date ; one bound for New York, 
and the other for New Orleans. The cholera broke out on board both those 
vessels, some time after they put to sea, and several passengers died on board 
of each. The New York ship was subjected to rigid quarantine on her arrival 
at that port, and the disease was thereby excluded from the city, although it 
spread all over the quarantine district. The New Orleans ship was permitted 
to enter the harbor without any restriction ; the consequence was, that the 
cholera spread throughout the city shortly after her arrival ; soon commenced 
travelling on its great highway, the Mississippi ; and, in the course of a few 
months, visited all the principal towns in the western states. This is at least 
the second occasion on which the ravages of this pestilence, in North America, 
may be attributed to the general disbelief in its contagiousness. There is 
scarcely a doubt that a rigid quarantine at Quebec, in 1832, and at New 
Orleans, in 1849, would, on each occasion, have excluded this pestilence. Nor 
is there any doubt that these quarantines would have been established, and 
enforced, had it not been for the reckless advice of mere theorizers, who, if 
they only had had a suspicion that they might be wrong, ought to have acted 
on the safe side — and scrupled to give advice which might bring upon millions 
of their fellow creatures the most dire calamity. 



PREVENTION OF CHOLERA. 137 

partial obstruction to commerce. It has been already 
observed, that during two years' extensive intercourse 
with infected places, but three vessels arrived in this 
country on which it was necessary to impose rigid 
quarantine : and even had it been considered expedient 
to prohibit those vessels from ever entering one of our 
ports, how trifling would have been the inconvenience, 
and how inconsiderable the loss, when compared with 
the evils of every kind, which the incursion of cholera 
occasions even in a single city — to say nothing of the 
desolations produced by it over the whole face of an ex- 
tensive continent ! It is calculated, that in the state of 
Louisiana alone, the pecuniary loss resulting from this 
scourge amounts already, to at least four millions of 
dollars ! and if we could estimate the destruction of hu- 
man life, the amount of human misery, together with 
the pecuniary losses which the whole country has sus- 
tained, even within the last twelve months, their magni- 
tude would appall us. It is unnecessary to insist on the 
propriety of enforcing the most rigid quarantine in every 
instance where there is a rational prospect of its success ; 
for did we entertain nothing more than a mere suspicion 
that cholera was contagious, we should even then be jus- 
tified in making almost any sacrifice which would afford 
a probability of excluding so dreadful a pestilence. 

The employment of sanatory restrictions by land, and 
especially between large commercial cities, offers much 
less prospect of success than by sea ; as it is extremely 
difficult, and indeed sometimes impossible, to cut off all 
communication with the infected. Where the inter- 



138 PREVENTION OP CHOLERA. 

course is very extensive, as, for example, between New 
York, Philadelphia and Baltimore, it is scarcely possible 
to exclude the disease, even by the most rigid quaran- 
tine ; and the evils resulting from the suspension of such 
extensive commerce are of serious magnitude. In all 
such instances, instead of wasting our efforts in vainly 
endeavoring to prevent the disease from invading us, it 
appears more advisable to calmly wait its arrival, under 
the protection of such judicious regulations as will enable 
us to extinguish it at its onset. 

Those regulations are such as must suggest themselves 
to every one who is aware of the contagious character 
of the disease. It is necessary, in the first place, that 
every town should, before the arrival of the cholera, be 
provided with at least one hospital, (the number of hos- 
pitals will of course be determined by the size of the 
town,) especially designed for the reception of cholera 
patients. This hospital should be so completely insu- 
lated, as to be several hundred yards distant from any 
dwelling ; — and so constructed, that each patient would 
have a separate apartment. The apartments should be 
spacious, well ventilated, and provided with the best of 
every thing necessary to the accommodation of the sick. 
The ablest physicians, and the most experienced nurses 
should be appointed; and all unnecessary intercourse 
between them and the other citizens strictly inhibited. 
Vehicles for conveying the sick, with their carriers, 
should be always found ready, at stated places; and 
these vehicles so constructed, as to afford comfortable 
beds, on which the patients might enjoy the recumbent 



PREVENTION OF CHOLERA. 139 

position, — at the same time that they would be entirely 
secluded from the public gaze. Those hospitals, with 
all their appurtenances, should, in short, be so judiciously 
constructed, and so well provided, as to present advan- 
tages to the sick, such as are seldom to be met with, 
even in the houses of our wealthiest citizens. Nothing 
which skill could devise, or money procure, for the wel- 
fare of the patients, should be spared in these institu- 
tions ; so that instead of being looked upon, as is gener- 
ally the case, with well-founded dread, they might be 
regarded, by every class of citizens, as asylums to which 
they would be glad to retreat. 

It would not be necessary, under such circumstances, 
to persuade, and much less to force patients to be taken 
to the hospitals ; as it would soon become known that 
the chances of recovery in these institutions were far 
greater than in their own dwellings. It is not probable, 
that among that class of citizens in which the disease 
generally makes its first appearance, an individual could 
be found, who would not be delighted to escape from the 
poverty and wretchedness of his miserable abode, to a 
place where he would find every comfort, and every 
attention. Indeed, the number of citizens, of any class, 
who might prefer remaining in their dwellings, would 
be inconsiderable ; for, besides the superior advantages 
which such hospitals would afford them, they would, by 
removing to them, preserve their own families from the 
most dangerous exposure. 

Were hospitals, such as I have here described, pro- 
vided by every town before the arrival of cholera, and 



140 PREVENTION OF CHOLERA. 

the persons first attacked immediately conveyed to them, 
it is probable that the disease might, in almost every 
instance, be arrested at its commencement. It is cer- 
tain, at all events, that by diminishing the points of 
propagation, the pestilence would be invariably checked, 
if not completely controlled. 

To co-operate with these views, it is important that 
the citizens should be strongly impressed with the injus- 
tice, as well as the folly of exposing themselves unneces- 
sarily to the influence of the poison. Did the evil of 
such exposure extend no further than to themselves, we 
might pardon, at the same time that we deplored their 
folly ; but when, by such rashness, they hazard not only 
their own lives, but also those of their more prudent 
fellow citizens — their conduct is highly censurable. 

All persons, whose circumstances will admit of their 
leaving the city, should at the first appearance of cholera, 
if not before its arrival, retreat to the country ; and 
there remain until the disease shall have entirely sub- 
sided. By doing this, they will be certain of securing 
themselves ; at the same time that their absence, by 
diminishing the chances of propagation, may tend, in no 
small degree, to the preservation of others. While in 
the country, they should avoid, as much as possible, all 
intercourse with infected places; and whenever such 
intercourse may accidentally occur, they ought, for some 
time afterwards, to be as strict in guarding against ex- 
citing causes as though they were residing in the city. 

They who may have delayed their departure from the 
city till the poison has become extensively diffused, 



PREVENTION OF CHOLERA. 141 

should be particularly careful to avoid all the ordinary 
exciting causes for at least two weeks after their arrival in 
the country ; as there are many facts to show, that the 
disease may sometimes be developed at a period even 
much longer than two weeks after exposure to its poison. 

We have strong reason to believe that the poison of 
cholera is emitted more copiously from bodies after death, 
than at any other period ; and this fact should forcibly 
admonish us of the propriety of early interments. As 
soon as a body is ascertained to be dead, no time ought 
to be lost in committing it to the grave ; and this office 
should be performed by as few attendants as possible. 
Funeral processions should, on such occasions, be avoided 
as being exceedingly dangerous ; and indeed every other 
unnecessary ceremony, which may occasion exposure to 
the poison, should be dispensed with. Every house, in 
which a death has occurred, should be well ventilated, 
besides being subjected to the influence of heat, light, 
chlorine gas, and other disinfecting agents ; and when 
circumstances will admit of it, the family should remove 
till after the different means of purification shall have 
been employed. 

The negroes on plantations, instead of being grouped 
together in contiguous cabins, should, at the approach of 
cholera, be scattered as much as possible. Temporary 
cabins might be erected on different parts of the planta- 
tion, in each of which not more than a single family 
should be permitted to reside ; so that if the disease did 
chance to make an incursion, its ravages might be confined 
to a limited number. Had the planters in the South and 



142 PREVENTION OF CHOLERA. 

West, adopted this mode of segregation, instead of per- 
mitting their slaves to have unrestricted intercourse 
with each other, thousands of lives might have been 
saved by it.* 

By the rigid observance of regulations such as these, I 
feel persuaded that the propagation of cholera may be in- 

* The same is true respecting the soldiers of our army, and indeed respect- 
ing all crowded assemblages of men. If segregation had been promptly re- 
sorted to in all cases which were practicable, whenever the cholera was ex- 
pected to invade a garrison or camp, there can scarcely be a doubt that very 
many lives would have been saved by it. The instances are very few in 
which segregation may not be conveniently practiced in our army, especially 
during times of peace ; and I hold that the medical officer who neglects to 
recommend this measure, because he presumes that the disease is not conta- 
gious — is guilty of a grave neglect of duty, and one which ought to dismiss 
him from the service. It is obviously the duty of those who have charge of the 
lives and health of the soldiers of our army, to always act on the safe side, in 
matters of this kind, whenever it is practicable to do so, whatever may be 
their own speculations on the subject. It is safe, and it is generally practica- 
ble, too, to remove troops from crowded quarters to healthy country encamp- 
ments, when cholera threatens to invade them ; the experience of armies in 
every country has proved that it is not safe to keep troops in crowded quar- 
ters under such circumstances ; and the medical officer who recommends 
that it be done, acts either from an unpardonable ignorance of the history 
of this disease, or else from an unjustifiable reliance on the truth of a 
theory. But it is not merely as respects cholera, that removal and segregation 
should always, when practicable, be promptly employed in our army. It is 
by no means certain, notwithstanding the great weight of authority on this 
subject, that yellow fever is not a contagious pestilence ; and indeed there is 
the strongest evidence to prove that it is. As long, then, as there exists a 
doubt on this question, why not give the benefit of that doubt to the troops ? 
This, it seems to me, would be only rational, just, and humane. Whenever 
a malignant disease of any description, (it matters not whether it be called epi- 
demic, endemic, or contagious) begins to spread in the vicinity of troops, they 
ought, whenever it is practicable, to be immediately removed to some healthy 
locality, and there encamped till after the disease shall have disappeared. If 
the disease be of ZocaZ-origin, as the non-contagionists generally assert, there 
is then the strongest reason for changing the locality. If the disease be con- 
tagious, it is obvious that crowded quarters are most favorable to its propaga- 
tion, and that the best prospect of escape is by segregation. In either view 
of the subject, there should be no hesitation as to the expediency of removal 
from an infected locality. 



PREVENTION OF CHOLERA. 143 

variably checked ; and that by paying, at the same time, 
a due regard to what I shall define to be the exciting 
causes, its total extinction may be very generally effected. 

2. The knowledge of the fact, that a large majority 
of those who have imbibed the poison of cholera may, 
nevertheless, by judicious management, obviate its 
effects, will, at the same time that it emboldens phy- 
sicians and others in the discharge of those offices 
which duty imposes on them, — impress upon all, the 
great importance of avoiding the causes which are known 
to act as exciters of the disease. Those causes, as has 
been before observed, are general and particular. The 
general exciting causes are all those whose ordinary 
effect is, either to derange the balance of the system, or 
to produce general debility. Sudden changes in the con- 
dition of the atmosphere ; inordinate exercise of the 
strong passions; the noxious effluvia proceeding from 
filth, vegetable decomposition, &c. ; immoderate eating 
and drinking, and the employment of quack preventives, 
are among the most prominent of them. 

The most effectual means of guarding against the first 
of these causes, are : to wear flannel next the skin ; to 
keep the feet dry and warm; to avoid the night air; 
and to adapt the clothing, as nearly as practicable, to 
the different changes of the weather. 

The hurtful influence of the passions can only be ob- 
viated by avoiding the causes by which they are inordi- 
nately excited ; and of these each individual will judge 
best for himself. The passion of fear, which, from its 
depressing effect, seems to exercise a specific influence 



144 PREVENTION OF CHOLERA. 

in exciting cholera, is frequently aggravated by news- 
paper reports, and by exaggerated statements of the 
ravages of the disease. They who are particularly ob- 
noxious to the influence of this passion should, therefore, 
abstain from reading those reports, and at the same time 
avoid all conversations on the subject.* 

The next cause, or that of noxious effluvia, may 
generally be obviated by the removal of all nuisances, 
the employment of disinfecting agents, and of other 
means which conduce to general cleanliness. Personal 
cleanliness ought also to be strictly attended to ; and with 
this view, the warm bath should be resorted to at least 
twice a week. 

Intemperance in eating, at all times injurious, is, 
during the prevalence of cholera, fraught with danger. 
Great prostration is generally experienced, even in the 

* While it is true that excessive fear of cholera has a tendency to develop 
the disease, and probably does develop it in some rare cases ; it is perfectly 
certain that for one death which results from this cause, there are at least one 
hundred which are occasioned by the want of a proper sense of danger. A 
very large proportion of those who die of cholera, die because they have not 
sufficient apprehension of the disease, to induce them to employ medical aid 
during the premonitory stage, in which it can be almost invariably cured. 
Another large proportion die in consequence of their fearless indulgence in 
fruits, vegetables, and other exciting causes of the disease ; and there is yet 
another large proportion who fall victims to the pestilence by their reckless, 
and unnecessary exposure to its poison. Fear, then, in its general influence 
on a community, is most salutary ; and probably tends more than any other 
cause to check the ravages of this disease. This, I am aware, is a heterodox 
doctrine, but extensive observation and reflection have convinced me that it is 
true ; and I would therefore suggest, as " a preventive measure," that boards 
of health, ought always to warn the citizens, as soon as the first cases of the 
disease appear, instead of suppressing, as they too frequently do, the truth on 
this subject. It is due to public safety, as well as to morality, that there 
should be no concealment — and any man who would deceive his fellow citizens 
in a matter in which all are equally and vitally concerned, merits the con- 
demnation of the whole community in which he lives. 



PREVENTION OF CHOLERA. 145 

most robust constitutions, during the digestion of an 
inordinate meal ; — and when to this prostration, we add 
the debilitating influence of a specific poison, we shall 
be at no loss to understand why so many persons are 
attacked with cholera immediately after indulgence in 
what is termed a " hearty meal." — By a hearty meal, 
may be generally understood, at least twice the quantity 
necessary for nutrition ; and although sound and vigor- 
ous constitutions are able, during periods of health, to 
resist, for a length of time, such repeated injuries, yet 
sooner or later a breach is made, and dyspepsia, or 
some other formidable disease, takes possession of the 
system. It is during the prevalence of epidemics, when 
the system of almost every one is, from exposure to a 
debilitating poison, reduced to a valetudinary state, that 
the evil consequences of such abuses are more especially 
manifest. " A hearty meal" has, during the prevalence 
of cholera, proved the last meal — to many an individual 
who, at other times, might have indulged in it with 
comparative impunity. It is therefore a great error to 
assert, that during the prevalence of cholera, or of any 
other pestilence, " our habits of living should be pre- 
cisely the same as usual ;" unless, indeed our usual 
habits be such as are precisely in accordance with the 
laws of health. 

It is scarcely necessary to observe, that intemperance 
in drinking, is another very general, and very powerful, 
exciting cause of cholera. The corresponding depression 
which necessarily follows a high degree of excitement, 
leaves the system a prey to the deleterious agency of the 
k 



146 PREVENTION OF CHOLERA. 

latent poison ; and it frequently happens that during the 
lethargy of debauch, the disease has made such rapid 
progress, that on waking, the drunkard finds himself in 
a state of hopeless collapse. 

It is true that some of the most abandoned drunkards, 
escape this disease, while many of the most temperate, 
fall victims to it ; and this fact has led superficial ob- 
servers to infer that intemperate drinking is an antidote 
to the cholera ! If, however, they contrast the proportion 
of drunkards who die of the disease, with that of the 
temperate, they will perceive the error of their conclu- 
sion. It should be remembered that all the drunkards 
who escape, have not necessarily imbibed the poison; 
and that that portion of the temperate who are attacked, 
may have been exposed to a variety of other exciting 
causes. 

The employment of nostrums, as " preventives to 
cholera," may be .classed among the most mischievous 
of its general exciting causes. To those in health they 
are invariably injurious ; and to such as are not, they 
are never beneficial, unless indeed by the merest acci- 
dent. When the system is so well balanced as to perform 
all its healthy functions, it is in the best condition to re- 
sist injurious agents of every kind ; and any attempt to 
improve on it, cannot, under such circumstances, fail to 
do mischief. It is, therefore, a great error for persons 
while in the enjoyment of health, ever to take medicine ; 
and especially medicine of which they know nothing, 
except from the interested statements of ignorant and 
unprincipled men. It is not until the system has so far 
lost its balance, that the derangement of its functions 



PREVENTION OF CHOLERA. 147 

becomes manifest, that medicine ought ever to be em- 
ployed ; and then, it is only the most skillful hand that 
should administer it. Municipal authorities should, 
therefore, protect the ignorant and the credulous from 
the evil of " preventives," by using all legal means to 
suppress the impostors who either vend — or administer 
them.* 

To the general exciting causes here mentioned, may 
also be added, fatigue either of body or mind ; long 
fasts; indigestible food, &c. 

Having already made some observations on the par- 
ticular exciting causes of cholera, it will only be neces- 
sary in this place, to enumerate a few of those which 
are considered the most powerful of them. 

Among the articles of diet derived from the vegetable 
kingdom, cabbages, cucumbers, turnips, green corn, 
melons, cherries, apples, peaches, and pears, may be 
considered the most frequent exciters of the disease. 

In the animal kingdom, crabs, oysters, clams, lob- 
sters, and fresh pork, are the most powerful. The most 
dangerous medicines are, the various neutral salts, castor 
oil, magnesia and drastric purges. 

There are, besides these, many other exciting causes 
too numerous to detail. In short there are but few 



* What is here said of " preventives," is not meant to apply to the class of 
remedies which are so efficaciously employed in the premonitory stage of cho- 
lera ; but simply to those nostrums which are taken by persons in perfect 
health, with the view to "keep off" the disease. Nothing is more certain 
than that various stimulants, such as ardent spirits, camphor, ammonia, capsi- 
cum, opium, &c, are often efficacious in breaking up the disease, when adminis- 
tered in its forming stage. It is important, too, that the public should be 
made aware of this fact, as the disease may be often averted, by their adminis- 
tration, before medical aid can be obtained. 



148 PREVENTION OF CHOLERA 

vegetables, and perhaps no fruits, that may be used 
with safety during the prevalence of cholera ; so that the 
best rule is, to confine our diet to such articles as an ex- 
tensive experience has approved. Of this character, are 
bread, rice, good potatoes, beef, mutton, lamb, veal and 
poultry. The safest drink, is pure water of a moderate 
temperature. 

Municipal authorities should, during the prevalence of 
cholera, prohibit, under a heavy penalty, the sale of such 
articles as are known to be powerful exciters of the dis- 
ease. It is not sufficient to warn the citizens of the 
fatal consequences of indulgence, so long as the tempta- 
tions to it are spread before them : the ignorant, the 
incredulous, and the inconsiderate, require, on such occa- 
sions, to be protected from themselves — and this can only 
be effected by placing the poisons beyond their reach. 

Such is a brief outline of the means which the doctrine 
of contagion suggests, for the prevention of cholera : and 
it will be seen, that they are essentially different from 
those which have been so generally employed under the 
prevalence of the opposite doctrine. If the doctrine of 
contagion be true, the means of prevention here recom- 
mended, must be substantially correct ; and their univer- 
sal adoption of infinite importance : if false, we then 
stand completely defenceless before this desolating 
scourge ; for the means of prevention recommended by 
the non-contagionists, although most extensively em- 
ployed, have never yet proved successful. It must re- 
main then for an enlightened public to decide, whether 
the cholera be contagious, and if so, to adopt the only 
means that will protect them from its ravages. 



TREATMENT OF CHOLERA. 



The terror with which cholera is so universally re- 
garded, may be entirely ascribed to the rapidity with 
which it passes through its different stages ; for if taken 
at the onset, there are but few diseases which may, by 
judicious treatment, be so readily controlled. Cholera 
is a disease in which there is not a moment to be lost; for 
in it, twenty minutes will oftentimes seal the fate of the 
patient. It is highly important, therefore, that every 
member of the community should be instructed in the 
means of arresting its fatal course ; for it frequently 
happens, even in our largest cities, that medical aid 
cannot be obtained for hours after an attack. 

As the few remarks which I shall offer on the treat- 
ment of this disease, are exclusively designed for popular 
instruction, it will be entirely unnecessary to premise 
any views of its pathology. A description of the promi- 
nent symptoms which mark its different stages, followed 
by some practical observations on the simplest and most 
efficient means of cure, is all that I shall attempt, as this 
is all that I conceive can be useful to the public. 

Cholera presents, in almost every instance, three 
stages : * the premonitory, the spasmodic, and the col- 

* In some instances, the attack of cholera is so sudden, and so aggravated, 
as to present but a single stage : the patient, without the slightest premonition, 
falls suddenly into a state of great prostration, attended sometimes, with in- 
sensibility. The pulse becomes almost instantaneously imperceptible at the 



150 TREATMENT OP CHOLERA. 

lapsed ; and it is necessary, for the purposes of medical 
treatment, that those different stages be distinguished 
from each other. 

The premonitory stage is characterized by a mild 
species of diarrhoea. This diarrhoea, although seldom 
attended with griping, is usually accompanied with 
several other unpleasant symptoms : such as general 
lassitude ; loss of appetite ; uneasiness, with a sensation 
of sinking, in the region of the stomach ; coolness of 
the feet and hands; giddiness, and sometimes pain in 
the head ; ringing in the ears ; twitchings of the mus- 
cles ; occasional numbness of the extremities, &c. The 
pulse is rather weaker than natural. The tongue moist, 
and covered with a whitish fur. The evacuations, at 
first, consist of the ordinary contents of the alimentary 
canal ; but gradually become of a lighter hue, and more 
fluid, till at length they assume the color and consistence 
of rice-water. 

These symptoms, all of which are seldom present in 
the same individual, may continue, varying in severity, 
from one to six days, before the second or spasmodic 
stage supervenes ; and during all this period, the patient 
generally attends to his ordinary avocations, without 
suspecting the dangerous character of his complaint. 



wrists, and the heat of the surface declines with great rapidity. Vomiting, 
purging, and spasms are either entirely absent, — or else manifested in but a 
slight degree. Indeed, the whole system seems so completely overpowered 
by the poison that scarcely a symptom of reaction appears. 

In the early part of this type (before the skin has become completely cold) 
blood-letting, and the other means which shall be recommended for the cure 
of the spasmodic stage, should be employed ; but when the blood has entirely 
deserted the surface, the treatment should differ in no respect from that of 
collapse. 



TREATMENT OF CHOLERA. 151 

To an experienced eye, however, he manifests, in a 
slight degree, that peculiar expression of countenance 
which is so characteristic of cholera : — his features are 
sharper than natural ; his eyes somewhat sunken ; and 
the whole expression of his face is one of fixed sorrow. 

If this form of the disease be left to itself, or be inju- 
diciously treated, the symptoms become aggravated, and 
the spasmodic stage supervenes. 

The spasmodic stage generally sets in with violent 
cramps, accompanied with severe vomiting and purging 
of a fluid resembling rice-water. The pulse is small and 
quick. The skin, though below the natural tempera- 
ture, is still warm. The countenance is much shrunk, 
and expressive of great anxiety. There is a distressing 
thirst, attended with a burning heat, and sometimes 
pain, in the region of the stomach. The cramps, though 
not constant, recur at short intervals in paroxysms of 
dreadful severity. This stage is of short duration ; for, 
if not promptly relieved, it soon terminates in that of 
collapse. 

The stage of collapse is distinguished by a deadly 
coldness of the whole surface of the body. The vomit- 
ing, purging, and thirst still continue. The pulse is 
barely, or not at all, perceptible at the wrists. The 
voice is low and whispering. The breathing oppressed. 
The tongue cold. The face, hands, and feet are of a 
bluish color ; and the palms and soles of the latter, cor- 
rugated. The skin has, in a great measure, lost its 
elasticity ; and is bedewed all over with a cold, clammy 
exudation. The cramps have either entirely subsided, 



152 TREATMENT OF CHOLERA. 

or else have lost much of their former violence. The 
secretion of urine is totally suspended. 

In the last degree of this stage, the pulse is entirely 
gone. The voice scarcely audible, and of a wailing tone. 
The features frightfully shrunk. The breath cold. The 
vomiting, purging, and cramps have now entirely ceased ; 
and the patient lies in a state of helpless exhaustion. 
Although apparently insensible, his mind continues un- 
impaired till the last ; and when roused, he will answer 
coherently, even a few moments before death closes the 
scene. 

This short description of the symptoms that mark the 
different stages of cholera will, I trust, be sufficient to 
enable persons generally, to make a discriminative ap- 
plication of the remedies which I shall suggest. These 
remedies are few and simple, and such only, as my own 
experience warrants me in recommending. 

As soon as an individual has reason to suppose that he 
is laboring under the premonitory symptoms of cholera, 
he should lose no time in applying his remedies; for, 
although this form of the disease, may sometimes con- 
tinue, with but little aggravation, for days, there is no 
security against its rushing, at any moment, into the 
spasmodic stage. Twenty grains of calomel, combined 
with five of camphor, should be immediately adminis- 
tered, the patient kept warm in bed, and a free perspi- 
ration promoted for several hours. Even this simple 
treatment, followed by a few days of repose, is all that 
is necessary in a majority of cases, to restore the patient 
to his usual health. If, however, the symptoms continue 
obstinate, after the medicine has had time to act, ^.ve 



TREATMENT OF CHOLERA. 153 

grains of calomel, combined with five of camphor, should 
be repeated at intervals of two hours, till an evident 
melioration has taken place. This will be invariably 
indicated by the character of the passages ; which, from 
having been light colored and watery, begin to resume 
their bilious tinge, and natural consistence. As soon as 
the secretions are completely restored, the further use of 
medicine is unnecessary ; but great care must be taken, 
during the period of convalescence, to avoid all exciting 
causes. With this view, the patient ought to keep his 
bed for several days, and be strictly guarded as to the 
character of his diet, which should be light, sparing, and 
nutritious. 

Although it is seldom necessary to bleed in this stage 
of the disease, yet, if the patient be plethoric, or if the 
symptoms be much aggravated, blood-letting ought by 
no means to be neglected ; as it will, under such circum- 
stances, be employed with great advantage, provided it 
be not carried to the extent of producing faintness. 
Cupping over the region of the stomach is also very im- 
portant, and will, in most cases, supersede the necessity 
of general depletion. 

Negroes on plantations, should be made to report them- 
selves regularly, every morning and evening, to their 
overseers, whenever the cholera is in their vicinity ; for, 
if left to themselves, they will almost invariably neglect 
the premonitory stage. Many of them have a great 
aversion to medicine, and, rather than be obliged to take 
it, will, if possible, conceal their symptoms. In order to 
remedy this, it will be necessary to appoint, from among 
themselves, some faithful spies, who shall be instructed 



154 TREATMENT OF CHOLERA. 

to give the earliest information of any symptoms of 
diarrhoea, which they may discover among their com- 
panions. 

Many persons, during the prevalence of cholera, ex- 
perience occasional numbness of the extremities ; slight 
vertigo ; sharp pains in the bowels ; and numerous other 
disagreeable sensations, unaccompanied with diarrhoea. 
These symptoms indicate that the system is strongly 
imbued with the poison of cholera; and should warn 
them particularly against exposing themselves to any of 
those causes which are known to act as exciters of the 
disease. Such symptoms may generally be dissipated 
by a few drops of spirits of camphor, a glass of good 
wine, or any stimulating cordial. 

The premonitory stage of cholera may, by prompt 
and judicious management, be invariably cured ; but if 
left to itself, or if improperly treated, it never fails to 
run into the spasmodic form. 

After the spasms and vomiting have commenced, 
there is no time to be lost ; for if the disease be not 
promptly arrested at this stage, the transition to that of 
collapse is frightfully sudden. 

In the treatment of the spasmodic stage, we must not 
trust to the operation of any single remedy, however 
efficacious it may be ; for should this remedy chance to 
fail, the time will then have passed when others might 
have been useful. It is to a combination of measures 
that we must look for success ; and the influence which 
they will exercise on the different symptoms, must be 
vigilantly marked, and carefully directed. 

The remedial agents on which we must chiefly rely in 



TREATMENT OF CHOLERA. 155 

the spasmodic stage, are calomel combined with opium 
and camphor, dry heat, stimulating mercurial frictions, 
and cups applied over the region of the stomach. The 
patient, after having taken from twenty to thirty grains 
of calomel, combined with two of opium, and five of 
camphor, in one dose, should be immediately placed be- 
tween heated blankets, and every exertion made to 
produce a warm and copious perspiration. This will 
generally be effected by surrounding the body with bot- 
tles of hot water, bags of heated sand, or hot bricks. In 
conjunction with this treatment, friction of the legs and 
arms should be made under the blankets, with stimulat- 
ing mercurial ointment, and cups employed extensively 
over the stomach. As a general rule, blood-letting is 
not necessary ; but if the patient be robust, the spasms 
very violent, the skin still warm, and the pulse strong, 
it ought never to be neglected. I have frequently seen 
patients, who had been tortured by the most violent 
spasms, almost instantaneously relieved, as soon as a 
vein was opened ; and I have never yet seen the stage 
of collapse supervene, when general blood-letting had 
been judiciously employed in such cases. On the other 
hand, I have witnessed many cases, in the hands of phy- 
sicians who were " opposed to blood-letting under any 
circumstances in cholera," in which the patients, labor- 
ing under violent spasms, with warm skin, and strong- 
pulse, have suddenly rushed into hopeless collapse : 
when, in my opinion, a timely and judicious bleeding 
would have saved them. Yery generally a small bleed- 
ing will, in such cases, be sufficient ; but cases sometimes 
occur in which the depletion must be copious, before the 



156 TREATMENT OF CHOLERA. 

more violent spasms can be subdued. As a general rule, 
blood-letting, when expedient to employ it, may be 
carried, in an adult, to the extent of fifteen ounces, but 
should never be carried so far as to cause faintness. 
Stimulating friction is, in this stage of the disease, an 
important auxiliary ; it serves, by its revulsive action, 
to keep up the heat of the surface, and thereby to allay 
the violence of the spasms, and when mercurial, as it 
always should be, it cooperates with the calomel in re- 
storing the secretions. The compound mercurial oint- 
ment is the best for this purpose ; * but in case it cannot 
be had, spirits of turpentine, tincture of cantharides, 
cayenne pepper, powdered mustard, or any other stimu- 
lating substance may be employed. 

The distressing thirst, by which the patient is so con- 
stantly harassed, will be best assuaged by small lumps 
of ice, which should be allowed to dissolve gradually in 
the mouth. If ice be not convenient, cold water, in 
small quantities, may be substituted. 

Under the prompt employment of these measures, the 
vomiting and purging will generally be checked, the 
spasms allayed, and the heat of the surface restored ; but 
still the victory will not be complete ; and our exertions 
must not in the least relax, till the disease has been en- 
tirely subdued. 

As soon as the spasms shall have been in a great de- 
gree subdued, the opium should be discontinued, but the 
calomel and camphor should be repeated at intervals of 

* This ointment is composed of the following ingredients : Ung. Hydrarg. 
fort. lbss. Gum camph. dr. i. Pulv. capsici dr. iss. 01. caryoph. dr. ii. 

Mt. ft. Ung. 



TREATMENT OF CHOLERA. 157 

half an hour, in doses of five grains each, and this repeti- 
tion continued until the passages shall have resumed 
their natural color, the secretion of urine shall have been 
restored, and every unfavorable symptom shall have 
disappeared. 

The grand indication for the cure of cholera, in all its 
stages, is to restore the secretions ; and to accomplish 
this, there is no agent with which we are acquainted so 
powerful as mercury. It is impossible, therefore, that 
patients can go wrong in endeavoring, before the arrival 
of a physician, to bring their systems under the influence 
of this remedy ; for it is one which will generally save 
life, if promptly and copiously employed in this stage of 
the disease. 

The treatment in collapse differs materially from that 
which is employed in the other stages of cholera. Dif- 
fusible stimulants, large doses of calomel, and powerful 
astringent injections, are the remedies on which we 
must mainly rely. In this stage, blood-letting is fatal ; 
and frictions of every description are useless, if not per- 
nicious. Our principal aim should be, to raise the sink- 
ing powers of the system by stimulants, while we endea- 
vor, at the same time, to equalize them, by the exhibition 
of calomel. 

The best stimulants for this purpose are, spirits of cam- 
phor, sulphuric ether, ammoniated alcohol, tincture of 
prickly ash, and the various species of ardent spirits.* 

* Galvanism is also a most important auxiliary in the treatment of this stage ; 
and should never be neglected when it can be conveniently applied. 

Professor Nathan R. Smith, of Baltimore, has employed it in several in- 
stances with signal advantage, even after the condition of the patient appeared 
entirely hopeless. Fifty pairs of three and a half inch plates were employed, 



158 TREATMENT OF CHOLERA. 

In administering those stimulants, we should have 
no reference whatever to the doses given on ordinary 
occasions ; — for, the system when collapsed, is in such a 
state of utter prostration, that nothing but the most 
powerful stimulation will rouse its dying energies. It 
is impossible to say with precision what quantity of any 
stimulant should, under such circumstances, be given at 
a dose ; as this must in a great measure depend on the 
degree of collapse to which the patient has been reduced, 
as well as on the manner in which his system will re- 
spond to the different remedies employed. In my own 
practice, I have seldom given less than half a wine glass 
of spirits of camphor the first dose; and this I have 
generally had occasion to repeat several times, at inter- 
vals of half an hour. 

If the camphor be rejected, other stimulants should 
be administered in doses of proportional magnitude, and 
repeated according to circumstances. Each dose of sti- 
mulus should be promptly followed by one of calomel, 
and this succession of remedies kept up till the condition 
of the patient shall have been evidently improved. From 
forty to sixty grains of calomel may be given at first, and 
from five to ten every half-hour afterwards, till the secre- 
tions have been completely restored. 

Injections are of great importance, and ought not to 
be delayed a moment. The most beneficial are such as 



with diluted muriatic acid. The wire of one of the plates was applied at 
various points along the superior part of the spine. To render it more efficient 
the integuments were scarified, and a metalic plate (a piece of coin) was ap- 
plied to receive the wire. The other pole was similarly applied to the epigas- 
trium. The skin was allowed to be besmeared with the blood which issued 
from the scarification. 



TREATMENT OF CHOLERA. 159 

are both stimulant and astringent. — A quart of hot wa- 
ter, (hot as it can be borne,) mixed with half a pint of 
brandy, and saturated with alum, is one of the best and 
most convenient.* — Even after the rice-water discharges 
have entirely ceased, injections of brandy and water, 
spirits of turpentine, &c, may be employed with great 
advantage as stimulants, and should be repeated accord- 
ing to the urgency of the case. 

As soon as the heat of the surface has begun to return, 
(and not sooner,) stimulating frictions, and all the other 
means recommended in the second stage for promoting 
perspiration, should be employed. 

Great care must be taken, both in this and in the 
spasmodic stage of cholera, to prevent the patient from 
rising, on any occasion, from the horizontal position, be- 
fore recovery is complete ; — as the instances are numer- 
ous in which relapse and death have resulted from the 
neglect of this precaution. , 

So dreadful is the mortality which generally attends 
collapse, that many believe the disease to be totally 
incurable after it has reached this stage. f This, how- 



* This form of injection should also be employed in the spasmodic stage, 
whenever the rice-water dejections are copious and obstinate. 

f In consequence of the great mortality which attends this stage, cholera is 
generally classed among the opprobria medicorum; although there is perhaps 
no disease, when properly considered, which affords such striking evidence of 
the efficacy of medicine. Cholera is a disease which is invariably fatal if left 
to itself— and one which is almost invariably cured if judiciously treated, either 
in its first or second stage— were it even true, then, that the stage of collapse 
baffled medical skill in every instance— the fact would argue nothing against 
the curability of the disease. As well might we class pleurisy,, dysentery, and 
other diseases, whose curability is not doubted, among the opprohria medico- 
rum, because, when permitted to reach their last degree, patients never recover 
from them. 



160 TREATMENT OF CHOLERA. 

ever, is a most erroneous opinion, and one that is pro- 
ductive of much mischief; as it oftentimes causes medi- 
cal treatment to be prematurely abandoned, under the 
impression that the condition of the patient is beyond 
its reach. — It is well known to those who have had 
much experience in the treatment of cholera, that col- 
lapse (except in its last degree) is frequently cured : and 
that sometimes, under the most unpromising circum- 
stances — even after hope itself has vanished, an unex- 
pected change takes place, and the patient recovers. 
We should, therefore, make it a principle in the treat- 
ment of this disease, never to relax our curative efforts, 
much less abandon our patient, so long as a spark of life 
remains. 






LIBRARY OF CONGRESS * 



029 827 874 1 



S* 



A 










,V# 



ft 



» 






■#*, 



• . 






£ 




